Hepa-RG cells stimulated with exosomes derived from 20 NAFLD patients expressed significantly higher levels (*P < 0.05 or **P < 0.001) of ELOVL6, SCD1, TNF-α, RIP-1, and MLKL, as compared to Hepa-RG cells treated with exosomes derived from healthy subjects. Here, ELOVL6 is linked to metabolic dysfunction-associated steatotic liver disease.