TGR5 agonists have the potential to be an effective treatment for metabolic diseases, such as NAFLD/NASH, owing to their ability to lower glucose-stimulated insulin release, slow gastric emptying, and decrease food intake via stimulation of GLP-1 release, and improve intestinal barrier function, thereby lowering whole body inflammation, via GLP-2 production (3, 5, 8, 22, 31, 35). Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.