Our findings offer dual strategies: repurposing AdipoR1 agonists (e.g., AdipoRon) or reducing circulating KAL (e.g., via genetic ablation or triglyceride-lowering agents such as fenofibrate), both applicable to diabetes/MASLD-related metabolic myopathy. This evidence concerns the gene SERPINA4 and metabolic dysfunction-associated steatotic liver disease.