Abstract To effectively evaluate insulin resistance (IR) in obese children and prevent chronic diseases, the review systematically elucidates the physiological significance and clinical utility of lipid accumulation product (LAP) in IR assessment of obese children. LAP can effectively reflect visceral fat accumulation and lipid metabolism disorders, and correlates with the core pathological indicators of IR. It also shows better diagnostic efficacy in identifying IR than traditional anthropometric measurement indicators; its dynamic changes can monitor the effectiveness of lifestyle interventions and drug treatments, facilitating the formulation of personalized intervention plans strategies for obese children. Future research should focus on the metabolic characteristics of Chinese children and adolescents, establish localized and standardized LAP reference values, and provide evidence based support for exploring precise comprehensive intervention measures and improving the metabolic health of obese children.