INS and metabolic dysfunction-associated steatotic liver disease: Zhang et al found that CSS reduced lipid levels and improved symptoms in patients with NAFLD.[17] Some studies have indicated that CSS may significantly decrease fat accumulation in NAFLD rat livers by modulating biological processes, such as fatty acid production, insulin resistance, inflammatory response, and gut microbiology.[18–21] However, the clinical effectiveness of CSS in the treatment of NAFLD is uncertain owing to a variety of problems, such as limited sample numbers, uneven research protocol design, various assessment measures, and low methodological quality.