Adipokines play a central role not only in the genesis of MAFLD but also in digestive diseases linked to obesity such as cholelithiasis, Barrett’s esophagus, and esophageal and colorectal cancer, as well as in pancreatic neoplasia and diabetes, with the two main adipokines being adiponectin and leptin, and, to a lesser extent, omentin, resistin, vaspin, and visfatin [56,137,138,139]. The gene discussed is SERPINA12; the disease is obesity due to melanocortin 4 receptor deficiency.