Metformin, a biguanine insulin-sensitizing drug, and other T2D medications have been explored for the treatment of NAFLD, but while some success has been shown with high doses in HepG2 cells8,9 and rodent10 models, metformin has not been shown to improve liver histology in human clinical trials11,12. This evidence concerns the gene INS and metabolic dysfunction-associated steatotic liver disease.