Non-alcoholic fatty liver disease, recently renamed metabolic-associated fatty liver disease, is a feature of T2D and metabolic syndrome [31].The NAFLD pathway contains genes relevant to insulin signalling and mitochondrial function (Additional file 4: Table S1), further suggesting metabolic and signalling dysregulation in astrocytes and links to peripheral dysmetabolism. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.