Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent and severe global liver disorder that requires effective therapeutic strategies. Glucagon-like peptide-1 (GLP-1RA) receptor agonists, along with glucose-dependent insulinotropic polypeptide (GIP) and glucagon (GCG) receptor dual or triple agonists, modulate multiple metabolic pathways. These drugs have attracted significant scientific interest due to their multifaceted roles in metabolic regulation. The review provides a comprehensive mechanistic view of their effects on the pathophysiology of MASLD. It focuses on liver lipid metabolism, inflammatory responses and fibrosis progression. GLP-1RA and dual/triple agonists act on these processes in the liver.