INS and fatty liver disease: • Induces Pre-adipocyte differentiation. • Reduction of insulin-induced glucose transport. • Inhibition of glucose uptake by adipocytes via ERK signaling. • Acts synergistically with TNFα and IL6, altering the lipase activity, leading to lipid accumulation in the liver and muscle. • Contribution to hepatic lipogenesis, triglyceride accumulation, and development of hepatic steatosis. • IL6 production. • T cell and macrophage activation.