In this light, we fill this gap in knowledge by conducting a head-to-head analysis and assessing the efficacy of the three-novel glucose-lowering drug classes (SGLT-2 inhibitors, GLP-1RAs and DPP-4 inhibitors) and their effectiveness on liver fat content i.e., HDL, LDL, triglycerides and total cholesterol in patients with T2DM with or without NAFLD as our primary outcome. This evidence concerns the gene DPP4 and metabolic dysfunction-associated steatotic liver disease.