After bioinformatics analysis and functional validation, ACC1, a limited enzyme in fatty acid metabolism, exhibited significantly upregulated expression in resistant groups (both exosomes and cells) compared to sensitive groups, and stabilized fatty acid oxidation (FAO) and reactive oxygen species (ROS) levels, ultimately enhancing the survival capacity of NSCLC cells under treatment with gefitinib. This evidence concerns the gene ACACA and non-small cell lung carcinoma.