MS showed smaller effect sizes, with genetically predicted increased expression of NSUN3 (OR: 1.002; 95% CI: 1.001–1.002; p = 1.42 × 10−8) and NLRX1 (OR: 1.001; 95% CI: 1.000–1.002; p = 0.014) associated with elevated risk, implicating mitochondrial RNA modification and immune regulation, while SLC25A39 (OR: 0.999; 95% CI: 0.998–0.999; p = 9.12 × 10−5) and BCL2L1 (OR: 0.999; 95% CI: 0.998–0.999; p = 2.80 × 10−7) was causally linked to reduced MS risk, suggesting protective roles in amino acid transport and apoptosis regulation. Here, SLC25A39 is linked to myeloid sarcoma.