NAMPT has recently attracted a lot of concern in various domains like NAD biology, inflammation, and metabolism. NAMPT is vital in the biosynthesis of NAD+ which is essential in the metabolism of energy in different organisms; and modifies the effect of NAD-consuming enzymes like sirtuins. The combined effect of NAMPTmediated NAD+ biosynthesis and SIRT1 is paramount in regulating various biological mechanisms such as metabolism, cellular differentiation, stress response, and circadian rhythm and mediating conformational responses to restricted energy consumption like fasting and limited diet. Though, a defect in adipose NAMPT-mediated NAD+ production results in significant multi-organ insulin resistance, which is a consequence of obesity-related systemic metabolic dysfunction. In metabolic syndromes like T2D, polycystic ovarian syndrome, or gestational diabetes NAMPT level is usually elevated. As a result, this review focuses on the role of NAMPT in the adipose tissue, since it’s a major ground for eliciting its activities