After adjusting for age, BMI ≥ 27 kg/m2, T2D duration, Hb, GOT, GPT, log-formed TG, metformin usage, habit of smoking, alcohol drinking, history of hypertension, gout, and hyperlipidemia, the T2D patients with low levels of circulating isobutyrate (odds ratio (OR): 0.17, 95% confidence index (CI): 0.03–0.86) and methylbutyrate (OR: 0.25, 95% CI: 0.08–0.76) levels had an increased risk of moderate to severe NAFLD. The gene discussed is GSTM1; the disease is metabolic dysfunction-associated steatotic liver disease.