With the rise in obesity due to economic and medical developments and changes in dietary habits, there is an urgent need for effective interventions. Obesity is characterized by an imbalance in energy, with increased intake and decreased consumption. While previous studies have focused on peripheral organs, recent emphasis has been placed on the role of the hypothalamus in energy metabolism. Hypothalamic neural stem cells (htNSCs) which control adult neurogenesis play a crucial role in sensing the metabolic state of the body and maintaining energy balance by altering differentiation pathways, exosome functions, and mitigating inflammatory. By studying the hypothalamus and htNSCs, we can gain a better understanding of the mechanisms behind energy metabolism disorders in obesity and identify potential therapeutic targets for obesity and metabolic syndrome.