Most of the existing studies have focused on the regulation of core molecules of the AMPK pathway (such as ACC, mTOR, and SEBP-1C), but its interaction with other metabolic pathways (such as PI3K/Akt, FGF21, and the gut microbiota-liver axis) has not been fully clarified, which limits the comprehensive understanding of the complex regulatory network in NAFLD. Here, ACACA is linked to metabolic dysfunction-associated steatotic liver disease.