INS and metabolic dysfunction-associated steatotic liver disease: In patients with non-alcoholic fatty liver disease (NAFLD), the combination of physical exercise with decreased caloric intake is clearly beneficial; small reductions in body weight (between 6% and 10%) improve insulin sensitivity, decrease the necroinflammatory activity assessed by alanine aminotransferase (ALT), and improve lobular inflammation, ballooning, and steatosis [5,6].