This study assessed the anthropometrics and acanthosis nigricans (AN) in a sample of 7,337 children at two assessments. Four groups of children were identified based on the presence of AN at both time points: those who never had the marker, those who gained the marker, those who lost the marker, and those who maintained the marker. Group differences in height, weight, body composition, and the amount of change in these variables over time were explored. Our findings demonstrated that children who maintain or gain the AN marker had the greatest height, weight, and body composition changes over time. It is apparent that the AN marker does disappear in some children and that this is associated with lower weight gain and body composition loss. If interventions can be developed targeting children who present with the marker, it is likely that their risk of developing type 2 diabetes could be reduced.