As increased hepatic DNL in obese NAFLD patients has recently been reported to be inversely correlated with hepatic and whole-body insulin sensitivity and directly correlated with the 24 h plasma glucose and insulin concentrations [186], it is still possible that enhanced hepatic insulin signaling resulting from hyperinsulinemia in cases of NAFLD directly promotes hepatic DNL. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.