Early ECM remodelling is associated with obesity-associated insulin resistance in skeletal muscle, liver, and adipose tissue, where increased deposition of ECM components (e.g., collagens and HA) and their interaction with membrane bound receptors such as integrins and CD44 contribute to insulin resistance in obese mice [15,56,57,58]. The gene discussed is CD44; the disease is obesity due to melanocortin 4 receptor deficiency.