Therapeutic extracellular vesicles (EVs) predominantly accumulate in the diabetic liver, delivering miR‐31‐5p to suppress macrophage platelet‐derived growth factor B (PDGFB), thereby impeding non‐alcoholic fatty liver disease (NAFLD) progression and enhancing neurovascular health by promoting pericyte recovery and transthyretin (TTR)‐mediated hippocampal homeostasis through cross‐organ (liver‐brain axis) repair. This evidence concerns the gene PDGFB and metabolic dysfunction-associated steatotic liver disease.