Taken together, ADSC-EVs deliver miR-223-3p to negatively regulate E2F1 expression, and then reduce lipid accumulation and liver fibrosis in NAFLD mice; accordingly, miR-223-3p-loaded ADSC-EVs and E2F1 knockdown were both demonstrated to ameliorate NAFLD. The gene discussed is E2F1; the disease is metabolic dysfunction-associated steatotic liver disease.