The negative energy balance derived from glucose urinary excretion and from the increased glucagon/insulin ratio that promotes substrate utilization shift from carbohydrates to lipids may explain the beneficial role of SGLT2 inhibitors in NAFLD [249,251]; the weight loss and the increased insulin sensitivity may contribute to the SGLT2 inhibitors effect though, as mentioned above, this is still unclear [248,250]. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.