Subgroup analyses revealed that: older adults with obesity or MetS derived the greatest benefits; moderate-to-high intensity combined aerobic-RT (3–5 sessions/week, 30–60 min/session, ≥12 weeks duration) was the most effective, with VPA showing superior TNF-α-lowering effects compared to MVPA; short-term interventions (<6 months) were more suitable for inflammation control, while long-term interventions (≥6 months) exhibited more sustained BMI improvement. Here, TNF is linked to obesity due to melanocortin 4 receptor deficiency.