INS and metabolic dysfunction-associated steatotic liver disease: Hrd1 interacts with and ubiquitinates Acly, reducing its protein levels, inhibiting acetyl coenzyme A levels, and suppressing lipogenesis; in db/db mice and isolated mouse primary hepatocytes, hepatic Hrd1 expression was negatively correlated with NAFLD, whereas Hrd1 overexpression enhanced insulin sensitivity, ameliorated hepatic steatosis (122).