In the past few decades, the prevalence of obesity has increased not only in Western countries but also in Asia. Obesity is frequently accompanied by unhealthy adipocyte expansion; this results in a condition known as metabolic abnormal obesity, in which lipid spillover and abnormal adipocytokine secretion from adipose tissue elicit insulin resistance, a hallmark of type 2 diabetes mellitus . In addition, several studies have suggested that metabolic abnormal obesity may contribute to the development of pancreatic β cell failure, another hallmark of Type 2 diabetes (Figure 1). Although most clinical data supporting this scenario of Type 2 diabetes development are from studies in rodents, it may also be applicable to humans. Even though Asians generally have less severe obesity than Caucasians, they are susceptible to developing metabolic abnormal obesity. Also, Asians are believed to be susceptible to β cell failure . Thus, this scenario may apply not only to Caucasians, but also to Asians. Indeed, several recent studies suggested that this scenario may be applicable in Asian subjects. Here, we introduce recent findings regarding this topic.This article is protected by copyright. All rights reserved.