Our data defined acupuncture as an effective and important treatment strategy for T2DM with NAFLD, and proved that acupuncture can reduce lipid storage in hepatocytes, inhibit de novo synthesis of fat, promote oxidation of fatty acids, and then reduce the risk of hepatocyte steatosis, by regulating the expression of Aox1, Acot2, Plin2, Acc, Me1, Fasn, Acly, and Fabp2. This evidence concerns the gene ACOT2 and metabolic dysfunction-associated steatotic liver disease.