Abstract: Negative energy balance, mobilization of body fat for energy, and release of free fatty acids（FFA） in perinatal cows are the initiating factors of ketosis. Insulin, as a key hormone that inhibits the release of FFA, cannot play its physiological role well due to peripheral insulin resistance during lactation and reduction of postpartum insulin levels. This paper aims to elaborate the main insulin signaling pathways related to lipid metabolism and glucose metabolism, including but not limited to PI3 K signaling pathway and MAPK signaling pathway, as well as the effects of adipokines on insulin sensitivity through these pathways in perinatal period of dairy cows, so as to provide a theoretical basis for further study on the pathogenesis and explore the targets for treatment or prevention of ketosis.