The findings from the IMPROVE‐T2D study demonstrate that VSG leads to rapid and sustained reductions in pro‐inflammatory ectopic fat depots, including HFF, VAT, EAT and PAT, alongside significant improvements in weight, SAT, insulin sensitivity, lipid profiles, SBP, MAP, RHR, LV mass and CO in youth with T2D, all of which remained significant while controlling for weight loss. Here, INS is linked to type 2 diabetes mellitus.