The main findings of our cross-sectional study are as follows: (a) in Caucasian men with non-insulin-treated T2DM, lower plasma high-molecular-weight adiponectin levels were significantly associated with ~ threefold and sixfold odds of either hepatic steatosis alone or NAFLD with coexisting significant fibrosis, and (b) these associations remained statistically significant even after adjusting for age, adiposity measures, duration of diabetes, HOMA-IR score, the PNPLA3 rs738409 variant, or other genetic variants associated with greater susceptibility of NAFLD and fibrosing NASH. This evidence concerns the gene ADIPOQ and metabolic dysfunction-associated steatotic liver disease.