Metabolic associated fatty liver disease (MAFLD) is a chronic liver disease closely associated with metabolic syndrome, characterized by a complex pathogenesis involving genetic, environmental, and lifestyle factors. Recent studies have shown significant disparities in the prevalence rate and clinical features of MAFLD across different racial and ethnic groups, and such disparities might be associated with various factors such as genetic background, environmental factors, socioeconomic disparities, and metabolic profiles. This article reviews the latest research advances in racial and ethnic differences in MAFLD in China and globally, discusses its potential pathogenic mechanisms and clinical significance, proposes future research directions and interventional measures, and emphasizes the critical need to enhance MAFLD screening and preventive health education in multiethnic populations.