Genetic variations in AKT1 have been associated with NAFLD risk.[33] Forkhead box protein O1 (FoxO1) is the main target of insulin action, possibly leading to lipid and glucose metabolism disorders after being activated.[34] Adiponectin can improve NAFLD by inhibiting the FoxO1 expression via AKT1/FoxO1 signaling pathway.[35] In a study by Jiang,[36] that an NAFLD mouse model expressed lower levels of AKT1 and higher interleukin-6, mitogen-activated protein kinase 1, caspase 3, p53, and vascular Endothelial Growth Factor A compared to those observed in the normal group. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.