miR-let-7b-5p is also enriched in pancreatic cancer cell-derived EVs and can promote lipid accumulation, upregulate FOXO and STAT3, and downregulate IRS1 and GLUT4 in C2C12 skeletal muscle cells, indicating a role in the development of insulin resistance (Wang et al., 2023). Here, IRS1 is linked to familial pancreatic carcinoma.