Maguolo A, et al. - Via searching the Cochrane Library and PubMed databases for papers published in English up to April 2019, researchers highlighted the clinical importance of acanthosis nigricans (AN) in childhood and draw attention to its possible role as early marker of alterations in glucose metabolism in obese children. Observational studies, case reports, and reviews were involved from 1994 till 2019. According to findings, most of the cases of AN are linked to obesity. The authors discovered that AN is a valuable clinical marker for recognizing obese and overweight children and adolescents with insulin resistance who are vulnerable to T2DM and metabolic syndrome. For clinical practice, AN awareness is useful for early identification of children and adolescents who are vulnerable to the insulin-resistant obese phenotype that might benefit from early intervention.