The possible mechanisms of Cilostazol include activating the AMPK-ACC1/SCD1 and AMPK-PGC1α-G6P/PEPCK pathways, regulating the structure and abundance of intestinal flora, SCFAs, and the intestinal barrier function, and finally achieving the effect of treating nonalcoholic fatty liver disease. This evidence concerns the gene PCK2 and metabolic dysfunction-associated steatotic liver disease.