Despite the clinical failures of some dual-PPAR agonists due to notable side effects, other multi-target PPAR activators, especially chiglitazar, saroglitazar, elafibranor, and lanifibranor, are quickly picking up the pace and have displayed outstanding efficacy in T2DM, dyslipidemia, NAFLD, and PBC. The gene discussed is PPARA; the disease is metabolic dysfunction-associated steatotic liver disease.