On the other hand, recent advances in microbiome and metabolite have also indicated the involvement of dysfunctional gut microbiome, dysregulated lipid metabolism, intestinal fructose handling and endogenous alcohol production, together with abnormal regulation and alterations of multiple signaling cascades (e.g., Hedgehog, BMP, TGF-β) for modifying the individual susceptibility to MAFLD patients with T2DM [24]. Here, TGFB1 is linked to type 2 diabetes mellitus.