Berberine, an approved antibacterial agent derived from a wide variety of Chinese traditional herbs, such as Coptis chinensis and Berberis vulgaris (Kong et al., 2020), has beneficial effects on NAFLD through diverse mechanisms, including the increase of insulin sensitivity, regulation of adenosine monophosphate-activated protein kinase (AMPK) pathway, improvement of mitochondrial function, and regulation of the gut microenvironment (Zhu et al., 2016; Wang et al., 2020). Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.