Compared with macrophages transduced with NAFLD-EVs + In-NC, levels of IL-1β, IL-6, and TNF-α in the macrophages, positive rate of CD86+ and CD11b+, and levels of IL-1β, IL-6, and TNF-α in the supernatant decreased in macrophages transduced with NAFLD-EVs + miR-9-5p inhibitor. This evidence concerns the gene IL6 and metabolic dysfunction-associated steatotic liver disease.