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The primary pathogenic causes of Acanthosis Nigricans (AN) linked to obesity and/or polycystic ovarian syndrome are Insulin Resistance (IR) and associated Hyperinsulinemia (HI). As an insulin sensitizing medication, metformin may provide AN with a targeted therapeutic strategy. In order to compare obese females with or without AN to obese females without AN, we looked at the correlations between the severity grade of AN and Body Mass Index (BMI), Waist-To-Hip Ratio (WHR), Insulin Resistance (IR), serum levels of Insulin-Like Growth Factor-1 (IGF-1) and IGF-1 binding protein (IGFBP-1), as well as the effectiveness of metformin in treating AN. We came to the conclusion that obese girls with AN have a higher prevalence of PCOS.