INSR and metabolic dysfunction-associated steatotic liver disease: Second, NAFLD and AFLD were found to be associated with impairment of insulin signaling and IR; while NAFLD-linked IR was noted to be a multifaceted process that involves several molecular processes working in concert; on the other hand, AFLD-linked IR was observed to be rather the consequence of TNFα-related signaling and subsequent local modulation of the insulin receptor-activated pathways.