Fatty acid synthesis primarily occurs by combining multiple 2-carbon units into a long chain. Specifically, this process involves combining lots of 2-carbon molecules, called acetyl-coenzyme A or acetyl-CoA, into a single 16-carbon, long chain fatty acid called palmitoyl-coenzyme A, or palmitoyl-CoA. Palmitoyl-CoA can then serve as a precursor to even longer chain fatty acids.
In summary, fatty acid synthesis is the creation of fatty acids from acetyl-CoA and NADPH through the action of enzymes called fatty acid synthases.