Literature from 2000 to October 2024 was then searched in PubMed, Embase, and Google Scholar for seven mechanisms, using the search terms “fetal alcohol spectrum disorder OR fetal alcohol” AND one of the following: “placenta,” “paternal,” “metabolism OR insulin OR amino acid,” “inflammation OR neuroinflammation OR cytokine,” “epigenetic,” “iron OR iron deficiency OR anemia,” “microbiome.” Only primary research articles, both clinical and preclinical, were included. This evidence concerns the gene INS and nutritional disorder.