Compared with SGLT-2 inhibitors, GLP-1 RAs decreased visceral fat (-0.560[-0.961 to -0.131]) and triglyceride (-0.607[-1.095 to -0.117]) significantly.<h4>Conclusions</h4>GLP-1 RAs effectively improve IR in NAFLD, whereas SGLT-2 inhibitors show no apparent effect.<h4>Systematic review registration</h4>PROSPERO https://www.crd.york.ac.uk/PROSPERO/, CRD42021251704. Here, GLP1R is linked to metabolic dysfunction-associated steatotic liver disease.