These observations underscore how the updated MASLD nomenclature more effectively captures patients with metabolic comorbidities, such as hyperglycemia and insulin resistance, thereby identifying those at greater cardiometabolic risk. Elevated HOMA-IR, fasting glucose, and insulin levels in MASLD patients, as reported by Hsiao et al. [34] and Oliveira et al. [32], underscore the role of underlying insulin resistance in driving type 2 diabetes pathogenesis within this population. This evidence concerns the gene INS and Insulin resistance.