KEGG analyses of top 10 DE exo-miRs showed that the top 30 enrichment pathways were mainly associated with metabolic pathways, environmental information/genetic information processing (e.g., endocytosis, signaling pathways of PI3K-Akt, MAPK and Ras, and protein processing in endoplasmic reticulum, etc), metabolism-related diseases (e.g., T2D, non-alcoholic fatty liver disease, and insulin resistance, etc), and organismal systems (e.g., insulin signaling pathway, platelet activation, and Toll-like receptor signaling pathway, etc), as shown in Figure 4. Here, AKT1 is linked to metabolic dysfunction-associated steatotic liver disease.