First, the incidence of NAFLD dramatically increases as MAT thickens,22, 23 and Bergman et  al suggest that MAT is a better predictor of insulin sensitivity than other depots of VAT.7 Next, in inflamed MAT, the cytokines and lipid decomposition products drained to portal vein are elevated, promoting the damage of liver.5, 6 Lastly, the inhibition of MAT inflammation can improve hepatic insulin resistance and hepatic steatosis.10 Nevertheless, the role of immune response within MAT is unknown. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.