CCS and gestational diabetes: Transcriptomic, single-cell, and animal analyses confirmed a CCS-high, inflamed, and collagen-rich microenvironment in CTS, whereas docking analyses indicated that CCS-centred pathways are pharmacologically tractable.<h4>Conclusion</h4>GDM exerts a causal effect on CTS, largely mediated through CCS-driven oxidative, immune, and fibrotic pathways.