Objective To evaluated the effect of sleeve gastrectomy on the psychological and quality of life in young obese patients with acanthosis nigricans. Methods A prospective clinical intervention study was carried out with 52 obese patients with acanthosis nigricans (body mass index≥28 kg/m2^{). and 50 healthy people were selec}ted as the control group. Beck Self-Rating Depression Scale-II was used to evaluate the psychological status, and the Chinese version of SF-36 was used to evaluate the quality of life of the subjects. The anthropometries parameters(weight,BMI,waist circumference),glucose metabolic indices[fasting plasma glucose (FPG),fasting insulin(FINS),glycosylated hemoglobin(HbAlc),homeostasis model assessment—insulin resistance index(HOMA-IR)], lipid profile (TC, TG, HDL-C, LDL-C) and inflammatory factor (CRP) were evaluated and calculated. Changes of these variables before and after surgery were analyzed. The correlation between depression and each detection index were analyze. Results LSG has effectively improved the depression and quality of life of obese patients with acanthosis nigricans. The scores of each dimension of quality of life preoperative assessment in obese patients with acanthosis nigricans group (AN group) were significantly lower than those the normal control group (P<0.05). The incidence of depression in the preoperative acanthosis nigricans group (AN group) (63.5%) was significantly higher than that in the control group (CON) (P<0.001), and the degree of depression was also significantly higher than that in the CON group (P<0.001). The levels of fasting insulin, insulin resistance, blood lipids and inflammatory markers (CRP) in AN group were significantly higher than those in CON group (P<0.05). After 12 months of surgery, patients in the AN group showed a significant decrease in blood lipids and inflammatory factors, as well as a significant improvement in high insulin and insulin resistance, as their weight decreased. Meanwhile, the mental health score in the SF-36 scale of AN patients significantly increased, and the depression score and degree also improved significantly. Depression in patients is positively correlated with BMI, insulin resistance, and inflammatory factors (CRP). Conclusions Bariatric surgery was an effective therapeutic approach for these obese patients with acanthosis nigricans because it improved both depression and the quality of life, along with improving of insulin resistance and metabolic disorder. Significant correlations were found between insulin resistance, CRP and depression.