Fatty acids are formed by the action of Fatty acid synthases from acetyl-CoA and malonyl-CoA precursors.
In humans fatty acids are predominantly formed in the liver and adipose tissue, and mammary glands during lactation. Most acetyl-CoA is formed from pyruvate by pyruvate dehydrogenase in the mitochondria. Acetyl-CoA produced in the mitochondria is condensed with oxaloacetate to form citrate, which is then transported into the cytosol and broken down to yield acetyl-CoA and oxaloacetate by ATP citrate lyase.
| Step | Description | Diagram | Enzyme |
| Condensation | The first step is condensation of acetyl ACP and malonyl ACP. This results in the formation of acetoacetyl ACP. Although this reaction is thermodynamically unfavourable, the evolution of CO2 drives the reaction forward. | β-Ketoacyl-ACP synthase | |
| Reduction of acetoacetyl ACP | In this step, acetoacetyl ACP is reduced by NADPH into D-3-Hydroxybutyryl ACP. The double bond is reduced to a hydroxyl group. Only the D isomer is formed. | β-Ketoacyl ACP reductase | |
| Dehydration | In this reaction, D-3-Hydroxybutyryl ACP is dehydrated to crotonyl ACP. | 3-Hydroxyacyl ACP dehydrase | |
| Reduction of crotonyl ACP | During this final step, crotonyl ACP is reduced by NADPH into butyryl ACP. | Enoyl ACP reductase |
In the second step of elongation, butyryl ACP condenses with malonyl ACP to form an acyl ACP compound. This continues until a C16 acyl compound is formed, at which point it is hydrolyzed by a thioesterase into palmitate and ACP.