This review article explores the role of adipose tissue in obesity-related inflammation and insulin resistance. Adipose tissue, a complex organ with diverse functions, is now recognized as an immune organ due to its presence of various immune cells, including adaptive and innate immune cells. Obesity leads to alterations in adipose tissue distribution and function, affecting cytokine, chemokine, and hormone expression, as well as lipid storage and immune cell populations. These changes contribute to systemic inflammation and insulin resistance. The article highlights the roles of key adipokines such as TNF-α, IL-6, leptin, adiponectin, and resistin in the development of insulin resistance and their effects on lipid metabolism and immune responses. It also discusses the role of chemokines like MCP-1 and CCR5 in macrophage recruitment and insulin resistance. Additionally, the article introduces myeloid-derived suppressor cells (MDSCs) as a novel actor in controlling insulin sensitivity, suggesting potential therapeutic targets for improving insulin resistance in obese individuals. The review emphasizes the importance of understanding the cellular and molecular mechanisms underlying obesity-related metabolic and immune complications to optimize long-term health outcomes.This review article explores the role of adipose tissue in obesity-related inflammation and insulin resistance. Adipose tissue, a complex organ with diverse functions, is now recognized as an immune organ due to its presence of various immune cells, including adaptive and innate immune cells. Obesity leads to alterations in adipose tissue distribution and function, affecting cytokine, chemokine, and hormone expression, as well as lipid storage and immune cell populations. These changes contribute to systemic inflammation and insulin resistance. The article highlights the roles of key adipokines such as TNF-α, IL-6, leptin, adiponectin, and resistin in the development of insulin resistance and their effects on lipid metabolism and immune responses. It also discusses the role of chemokines like MCP-1 and CCR5 in macrophage recruitment and insulin resistance. Additionally, the article introduces myeloid-derived suppressor cells (MDSCs) as a novel actor in controlling insulin sensitivity, suggesting potential therapeutic targets for improving insulin resistance in obese individuals. The review emphasizes the importance of understanding the cellular and molecular mechanisms underlying obesity-related metabolic and immune complications to optimize long-term health outcomes.