In the multivariate regression model, when DBP, duration of diabetes, HbA1c, hemoglobin, ALT, AST, GGT, albumin, BUN, TC, LDL-C, statin use and metformin use were adjusted, an evident increase in the ORs of MAFLD from the lowest to the highest CVAI quartile was found (P value for trend< 0.001), and the OR (95% CI) of MAFLD was 4.739 (2.778–8.085) for the highest quartile compared to the lowest quartile. This evidence concerns the gene ALB and diabetes mellitus.