I'm 37 320lbs 5'4 pelvic ultrasound=normal. Period only if take progest, Facial hair, fasting insulin46 ALT 76 labs Still have pcos with normal USound?

Yes. Many women with PCOS don't have visible ultrasound signs. You need to check testosterone levels, if high can cause facial hair and block ovulation causing menstrual disturbances. There is a link between PCOS, obesity and insulin resistant, your high fasting insulin indicates that. Monitor blood sugar very closely. There are several other blood test that can help confirm the diagnosis.