The development of NASH and HCC is associated with multiple parallel factors, in a theory called “Multiple parallel hits theory,”9 Insulin resistance,8 endoplasmic reticulum stress,10 lipopolysaccharide derived from the intestines,11 and oxidative stress12, 13 are associated with hepatocarcinogenesis through the modulation of many cancer driver genes and cancer pathway genes,14, 15 Nuclear factor E2‐related factor 2 (NRF2), a transcriptional factor, is a master regulator of the cellular adaptive response to oxidative stress.16 Here, INS is linked to cancer.