Novo Nordisk walked away from earlier acquisition talks for Akero Therapeutics before returning to complete a $4.7 billion purchase of MASH drug developer Akero, according to reporting on the deal process. The transaction adds Akero’s metabolic/NAFLD candidate to Novo’s portfolio and underscores continued consolidation among metabolic-disease specialists. The push and pull during negotiations illustrates integration and valuation tensions that can shape deal structures in biotech M&A.