Abstract
Glucagon-like peptide-1 receptor agonists are increasingly used in patients with type 2 diabetes mellitus and obesity, populations at high risk for metabolic dysfunction-associated steatotic liver disease and advanced fibrosis. Despite guideline recommendations, noninvasive fibrosis risk stratification remains inconsistently implemented, leading to delayed recognition of cirrhosis and related complications. We highlight the need to integrate routine fibrosis assessment into metabolic care pathways to optimize early detection, referral, and long-term liver outcomes.