Using spatial multi-omics, researchers identified shifting macrophage populations across the progression of MASLD and described markers that could support patient stratification in clinical trials. The work adds to mechanistic understanding of how immune microenvironments change as fatty liver disease advances. The study’s core contribution is mapping macrophage phenotypes in situ rather than relying solely on bulk signatures, enabling investigators to link disease stage with specific macrophage patterns. Those markers are intended to help separate patient subgroups based on underlying biology. The findings may influence future trial design by improving inclusion criteria and enabling more targeted endpoints tied to immune-state dynamics during MASLD progression.