Among them, metabolic modulators, exemplified by metformin, effectively regulate the Treg/Th17 balance of patients with RA through the activation of AMPK and the inhibition of key signaling pathways, such as mTOR, STAT3, and HIF-1, attenuating the inflammatory response and inhibiting osteoclast formation, thereby alleviating disease progression (219). Here, HIF1A is linked to rheumatoid arthritis.