Adipose Tissue Plasticity and Insulin Signaling in the Pathogenesis of Type 2 Diabetes

Obesity is a major cause of various metabolic disorders, including type 2 diabetes, nonalcoholic fatty liver disease (NAFLD) and cardiovascular diseases, in modern times. Fat tissue originally evolved as an organ to prepare for food shortages. However, when individuals consume excessive calories and engage in insufficient physical activity, it can lead to the excessive accumulation of lipids in white adipose tissue, potentially causing problems. In response to this excessive lipid accumulation extending to other tissues, insulin resistance is triggered in the body as a physiological response to prevent harmful effects. Additionally, in mammals, brown adipose tissue has evolved to generate energy and maintain body temperature. These inconspicuous defense mechanisms function coordinately to protect against systemic metabolic abnormalities affecting multiple organs. Understanding the dynamic nature of adipose tissues is now crucial for elucidating the details of the molecular abnormalities in obesity-associated metabolic diseases. This review outlines adipocyte plasticity and function with a focus on the physiological relevance and new pathways of insulin signaling.