The presence of non-alcoholic fatty liver disease (NAFLD, p = 0.028), serum gamma-glutamyl transferase (GGT) levels (p = 0.009), fatty liver index (FLI, p = 0.018) and the triglyceride glucose index, a surrogate marker of insulin resistance (TyG, p < 0.001), were higher in MetS+ individuals. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.