The possible explanation of the relationship between MASLD and adverse fibrosis might be: (a) MASLD is a hepatic manifestation of metabolic dysfunction, where systemic insulin-resistant and pro-inflammatory environment promotes the release of inflammatory cytokines such as LI-1β, IL-6, and TNF-β1 from liver immune cells [28]. The gene discussed is INS; the disease is metabolic dysfunction-associated steatotic liver disease.