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Key Points Nonalcoholic fatty liver disease (NAFLD) is present in 5060% of patients with type 2 diabetes mellitus (T2DM) and up to 45% of individuals with T1DM Insulin resistance and NAFLD are closely related: insulin resistance promotes hepatic lipid accumulation and liver injury and hepatic lipid and cytokine release promote hepatic insulin resistance T2DM increases the risk of cirrhosis and liver-related death in patients with NAFLD, whereas NAFLD may increase the risk of cardiovascular disease and overall mortality in T2DM T2DM is a risk factor for nonalcoholic steatohepatitis, which is associated with a more aggressive course and higher rates of progression to cirrhosis than simple hepatic steatosis NAFLD is an independent risk factor for the development of cardiovascular disease in patients with T1DM and T2DM For patients with T2DM and NAFLD, weight loss and exercise aim to improve insulin resistance