NAFLD is a complex disease, the development and progression of which require multi-hit combinations of various risk factors, including age, sex, ethnicity, dietary habits, hormonal status, genetic predisposition (e.g., polymorphisms of PNPLA3, TM6SF2, MBOAT1, or HSD17B13), epigenetic factors, and associated comorbid conditions (e.g., obesity, type 2 diabetes mellitus, obstructive sleep apnea, and gut dysbiosis) [4,5,24,25,26]. The gene discussed is PNPLA3; the disease is metabolic dysfunction-associated steatotic liver disease.