INS and obesity due to melanocortin 4 receptor deficiency: Consequently, insulin resistance in obesity hampers the efficacy of insulin in restraining the release of inflammatory and catabolic factors, furthering OA’s progression.[33] However, exogenous insulin and oral anti-diabetic medications exhibit pleiotropic effects, including anti-inflammatory properties[36,37] and cartilage protection,[38,39] offering therapeutic avenues against OA’s advancement.