Based on current evidence, it may be particularly suitable for middle-aged adults with overweight/obesity whose primary goals are weight loss and improved insulin resistance (45-60 min/session, 4 sessions/week, for ≥14 weeks).<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251131430. The gene discussed is INS; the disease is obesity due to melanocortin 4 receptor deficiency.