We comprehensively and simultaneously evaluated ectopic fat accumulation and organ-specific IR in insulin-target organs in Japanese people with NAFLD, and found the following: 1) the IRs in the liver, skeletal muscle, and adipose tissue were associated with each other, 2) indices of fat accumulation in the skeletal muscle and adipose tissue were not associated with their own organ-specific IR, and 3) liver fat was associated with skeletal muscle IR as well as hepatic IR, independently of age, sex, BMI and total fat mass (Figure S1). Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.