The frequency of the Thymine, T (TT) genotype of PLA2R1 rs3749117 in obese patients with MASLD was significantly higher than that in the healthy controls and patients without obesity with MASLD (61.5% vs. 48.5% vs. 45.5%, p = 0.025), and there was no significant difference between the healthy controls and patients without obesity with MASLD. This evidence concerns the gene PLA2R1 and obesity due to melanocortin 4 receptor deficiency.