INS and metabolic dysfunction-associated steatotic liver disease: As indicated earlier, about one-third of T2DM patients have NAFLD, and this could be due to several factor, as follows: (1) insulin resistance (IR) impairing the ability of insulin to suppress adipose tissue lipolysis, thereby resulting in excess hepatic uptake of free fatty acids; (2) T2DM could be a consequence of NAFLD due to changes in hepatokine secretion that favor the induction of inflammation and IR in peripheral tissues [27].