In this context, the aim of this study was to evaluate two parameters: (1) the prevalence of, and factors associated with, NAFLD and liver fibrosis in a cohort of patients with T2D followed at an outpatient tertiary university center, and (2) the prevalence of SNPs rs738409 in PNPLA3 and rs499765 in FGF21 and their association with NAFLD, liver fibrosis, and serum FGF21 and cytokeratin 18 (CK18) levels in this population. Here, FGF21 is linked to metabolic dysfunction-associated steatotic liver disease.