Background: Obesity and overweight are major worldwide health concern with significant health and economic effects. The ketogenic diet (KD), characterized by high-fat and low-carbohydrate intake, has emerged as a popular strategy for weight reduction and long-term benefits on insulin sensitivity and blood lipids. Aim: This systematic review aimed to assess the impact of ketogenic diets on insulin levels and lipid profiles in overweight and obese adults. Method: We conducted a systematic search in accordance with the PRISMA 2020 guidelines and the PICOS framework. Five interventional studies met the inclusion criteria, evaluating the effects of various forms of ketogenic diets compared to standard or non-ketogenic diets in adults aged 18–65 years with BMI ≥25 kg/m². Results: Across all studies, ketogenic diets led to significant weight loss, improved insulin sensitivity, and enhanced lipid profiles compared to control groups, with long-term benefits. Lipid results were largely favorable, with lower triglycerides and LDL cholesterol and higher HDL cholesterol, but significant variability was noted. Conclusion and Recommendations: The ketogenic diet was effective in enhancing insulin regulation and producing beneficial changes in lipid profiles between overweight and obese adults. While findings support its short-and medium-term efficacy, professional supervision is recommended. Further high-quality studies are needed to clarify long-term outcomes

Keywords: Diet therapy, Insulin sensitivity, Ketogenic diet, Lipid profile, Obesity, Weight loss.