INS and obesity due to melanocortin 4 receptor deficiency: Excess adiposity contributes to insulin resistance and complicates the management of hyperglycemia.[1] Moreover, many individuals with severe obesity tend to develop obstructive sleep apnea (OSA), further increasing the cardiometabolic risk.[2] In such patients, weight reduction has been shown to significantly improve both metabolic parameters and respiratory function.[3] Conventional approaches to T2DM treatment, including lifestyle modifications and the use of oral antidiabetic agents and insulin, often have limited efficacy in the presence of severe obesity.