The role of hepatokines (that directly modulate hepatic homeostasis) in the context of MASLD includes Angiopoietin-Like 3 (ANGPTL3), that impairs lipid clearance, being associated with dyslipidemia and steatosis; activin protects against fatty acid influx into the liver (beneficial regulator); fetuin-A promotes insulin resistance and hepatic lipid accumulation; FGF-21 (hepatic) increases fatty acid oxidation, with a protective role in MASLD. This evidence concerns the gene FGF21 and Insulin resistance.