The key findings are as follows: patients with T2DM-NAFLD comorbidity present distinct metabolic-inflammatory features; the NLR and IL-6 show remarkable value in differential diagnosis; the combined diagnostic model integrating the TyG, NLR, and IL-6 significantly enhances the recognition accuracy of T2DM-NAFLD comorbidity. This evidence concerns the gene IL6 and metabolic dysfunction-associated steatotic liver disease.