INS and metabolic dysfunction-associated steatohepatitis: Liver inflammation caused by NASH, associated with the presence of pro-inflammatory mediators such as leptin, resistin, IL-6, and tumor necrosis factor-alpha (TNF-α) and intestinal lipopolysaccharides (bacterial endotoxins), creates an obstacle to insulin signaling pathways, impairing the insulin uptake of glucose in peripheral tissues and the inhibition of liver glucose production.