The COVID-19 pandemic has affected social, psychosocial, and behavioral factors related to hepatic steatosis (SLD) and fibrosis. The study analyzed 6,090 adults from the NHANES survey before the pandemic (2012) and during the pandemic (2021–2023) using elastography and various measurements. The prevalence of MASLD decreased from 32.2% to 28.6%, mainly in men, while advanced fibrosis almost doubled from 2.6% to 4.2%, mainly in women. Higher income lost the protective effect against MetALD (ROR = 0.21), unemployment increased the risk of MetALD in women, and depressive symptoms enhanced the risk of ALD in men (OR = 5.31; ROR = 6.73). Physical activity ceased to protect against MASLD and ALD, smoking increased the risk of ALD (OR from 3.49 to 17.08), and dietary inflammation was associated with fibrosis. Longer weekend sleep provided women with protection against fibrosis. The pandemic brought about changes in the epidemiology of SLD and fibrosis with gender differences.