INS and obesity due to melanocortin 4 receptor deficiency: However, the patients in our dataset had concomitant obesity (mean BMI = 31) [16], and in obese individuals, including those with early-stage type 2 diabetes, compensatory hypersecretion can lead to elevated fasting and postprandial insulin levels, overriding the typical attenuation of the insulin response [28,29,30].