The insulin paradox in the pathogenesis of NAFLD refers to a tissue-specific paradox, where insulin in adipose tissue plays a central role by exacerbating peripheral lipolysis and free fatty acids’ (FFAs) transfer to the liver, while it fails to suppress de novo lipogenesis in the liver, thus fostering hepatic steatosis and promoting atherogenic dyslipidemia [6]. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.