Functional enrichment analyses revealed impaired mitochondrial protein import, autophagy, and oxidative stress responses.<h4>Conclusion</h4>These findings suggest that mitophagy dysregulation is an early and persistent defect in GDM, with MUL1, PINK1, TOMM7, and ATF4 emerging as potential biomarkers and therapeutic targets. This evidence concerns the gene ATF4 and gestational diabetes.