Secreted frizzled related protein 4 (SFRP4) is an antagonistic inhibitor of Wnt signaling and plays an important role in human development. Abnormal gene expression and protein secretion of SFRP4 result in the pathological changes. This review introduced the structural characteristics, tissue distribution and expression pattern of SFRP4 during embryonic development. As an inhibitor of Wnts signaling, SFRP4 plays a key role in regulating adipogenesis. In clinic, the level of SFRP4 protein in the serum of diabetic patients was abnormally increased, which was negatively correlated with insulin secretion, indicating that SFRP4 plays an important role in the process of glucose metabolism and insulin resistance. In recent years, SFRP4 has attracted extensive attention in the research of obesity and lipid metabolism. Systematic research on SFRP4 can not only provide information related to diseases, but also serve as a novel drug and treatment target.