Diabetes and fatty liver disease increasing year by year has shown a trend of the global epidemic, and the incidence of type 2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD) is significantly higher than the normal population. High-fat high-calorie diet, and more sit sedentary lifestyle, insulin resistance, type 2 diabetes, metabolic syndrome and its components are increased risk factors for NAFLD incidence. Insulin resistance is the basis of the pathology of T2DM with NAFLD. Cytokines like tumor necrosis factor, resistin, adiponectin, leptin, retinal pigment ,visceral fat adiponectin are involved in insulin resistance, and play an important role in the occurrence and development of T2DM with NAFLD. Weight control, healthy diet, improve insulin resistance is the principle of treatment of NAFLD, including weight control as the preferred treatment principles.