The article discusses the need to revise the nomenclature and terminology for metabolic-associated fatty liver disease (MAFLD) to better reflect its heterogeneous nature and improve clinical trial design and drug development. The current term, non-alcoholic fatty liver disease (NAFLD), is seen as inadequate due to its exclusionary and stigmatizing nature. The authors propose that MAFLD, which includes both alcoholic and metabolic causes, is a more appropriate overarching term. They emphasize the importance of considering the diverse causes and phenotypes of MAFLD, including age, gender, ethnicity, diet, alcohol intake, genetic predisposition, and gut microbiota. The article also highlights the impact of these factors on disease progression and treatment responses. The authors suggest that a revised nomenclature will facilitate more precise patient stratification, improve risk prediction, and enhance clinical trial design. They conclude by advocating for the adoption of MAFLD as the new standard term to address the heterogeneity of fatty liver diseases.The article discusses the need to revise the nomenclature and terminology for metabolic-associated fatty liver disease (MAFLD) to better reflect its heterogeneous nature and improve clinical trial design and drug development. The current term, non-alcoholic fatty liver disease (NAFLD), is seen as inadequate due to its exclusionary and stigmatizing nature. The authors propose that MAFLD, which includes both alcoholic and metabolic causes, is a more appropriate overarching term. They emphasize the importance of considering the diverse causes and phenotypes of MAFLD, including age, gender, ethnicity, diet, alcohol intake, genetic predisposition, and gut microbiota. The article also highlights the impact of these factors on disease progression and treatment responses. The authors suggest that a revised nomenclature will facilitate more precise patient stratification, improve risk prediction, and enhance clinical trial design. They conclude by advocating for the adoption of MAFLD as the new standard term to address the heterogeneity of fatty liver diseases.