Although previous studies have shown that some glucose-lowering drugs, such as GLP-1 receptor agonists with SGLT-2 inhibitors, can reduce the incidence of NAFLD [21,22], and SGLT-2i even significantly reduces hepatic fat content and improves hepatic function [23,24], and thiazolidinediones (e.g., pioglitazone) also reduce the risk of NAFLD by enhancing insulin sensitivity (HR = 0.66, 95% CI 0.55–0.78) [20,25], the results of the present study differ from this. This evidence concerns the gene INS and metabolic dysfunction-associated steatotic liver disease.