We previously hypothesized that TNF-α has a dual-faceted role in MASLD; it may initially activate nuclear factor-kappa B (NF-κB), i.e., a key transcription factor for the production of various cytokines, which mediates inflammation and supports the survival of hepatocytes, as a counteracting mechanism to limit lipotoxicity [21]. Here, TNF is linked to metabolic dysfunction-associated steatotic liver disease.