Gestational diabetes mellitus (GDM) refers to normal glucose metabolism before pregnancy but different degrees of glucose intolerance found during pregnancy. In recent years, with the improvement of national living standards, the awareness of prenatal examination of pregnant women has gradually increased, and the incidence of gestational diabetes has increased significantly. GDM is a serious threat to the health of mothers and children. Retinol binding protein 4 (RBP4) is a newly discovered cytokine produced by the liver and adipose tissue. It is responsible for binding and transporting vitamin A (retinol) in the plasma and let the vitamin A (retinol) exert physiological functions. Numerous experiments at home and abroad have confirmed that RBP4 is involved in the production and use of glucose and plays an important role in the development of insulin resistance in type 2 diabetes mellitus (T2DM). The subcutaneous adipose tissue and visceral adipose tissue affect the occurrence of T2DM insulin resistance to varying degrees. Insulin resistance is now recognized as an important pathogenesis of GDM. This article aims to study the role of RBP4 and adipose tissue in GDM and insulin resistance.