This multifaceted therapeutic approach, targeting key pathways, such as VDR for anti-inflammatory effects, VEGF for angiogenesis control, TGF-β for antifibrotic action, and Nrf2 for antioxidant defense, underscores the potential of vitamin D and metformin as promising therapies for mitigating the progression of DN and preserving renal function. Here, TGFB1 is linked to liver dysplastic nodule.