Adipose Tissue Immunometabolism as a Unifying Driver of Obesity and Type 2 Diabetes
Katu Amina H.
School of Natural and Applied Sciences Kampala International Uganda
ABSTRACT
Adipose tissue is now recognized as an immune organ as much as a fat depot. In obesity, expansion and stress of white adipose tissue (WAT) drive a coordinated rewiring of immune and metabolic pathways “immunometabolism” that links weight gain to insulin resistance and type 2 diabetes (T2D). Lean adipose tissue is enriched in type 2 immune cells (M2-like macrophages, eosinophils, ILC2s, regulatory T cells), which support insulin sensitivity, lipolysis, and thermogenesis. With chronic overnutrition, hypertrophic adipocytes become hypoxic, stressed, and dying; chemokines and lipotoxic signals recruit and reprogram myeloid and lymphoid cells toward pro-inflammatory, glycolysis-dependent phenotypes, forming crown-like structures (CLS) and amplifying cytokine production. Adipose tissue macrophages (ATMs) emerge as central hubs controlling lipid handling, mitochondrial function, thermogenesis, and systemic glucose homeostasis. This review synthesizes current knowledge on adipose tissue immunometabolism as a unifying driver of obesity and T2D. We outline the cellular landscape of adipose immune cells, their metabolic programs, and how obesogenic cues reshape ATM, T-cell, and innate lymphoid cell states. We then discuss how these immunometabolic shifts impair adipocyte biology, disrupt endocrine outputs, and propagate systemic insulin resistance and β-cell stress. Protective pathways involving brown and beige fat, type 2 immunity, and mitochondrial crosstalk are contrasted with inflammatory circuits. Finally, we examine evidence that lifestyle, weight loss, and pharmacologic therapies can remodel adipose immunometabolism, and highlight emerging immunometabolic targets and biomarkers for precision treatment of obesity-driven T2D.
Keywords: adipose tissue; immunometabolism; macrophages; obesity; type 2 diabetes
CITE AS: Katu Amina H. (2026). Adipose Tissue Immunometabolism as a Unifying Driver of Obesity and Type 2 Diabetes. IDOSR JOURNAL OF BIOCHEMISTRY, BIOTECHNOLOGY AND ALLIED FIELDS 11(1):63-70. https://doi.org/10.59298/IDOSR/JBBAF/2026/1026370