Betulinic acid could serve as an FXR agonist that effectively attenuates the pathogenesis of HFD and MCD induced NAFLD, and Alisma orientalis could restore the hepatocellular ER homeostasis by stimulating the FXR activation, particularly, Alisol A 24 (B 23)-acetate accounts for this action (Choi E. et al., 2019). Here, NR1H4 is linked to metabolic dysfunction-associated steatotic liver disease.