EVs mitigate DKD by inhibiting the TLR4/NF-κB pathway through cargo-mediated mechanisms (e.g., miRNA delivery), with key regulatory effects including suppression of TLR4/MYD88 phosphorylation, prevention of IκBα degradation and reduction in NF-κB nuclear translocation (50), blockade of NF-κB-driven TGF-β signaling and collagen synthesis (51), among others (Figure 10). This evidence concerns the gene TLR4 and diabetic kidney disease.