Akkermansia muciniphila (AM), one of the many microbial species residing in the human gut, has been particularly highlighted for its potential beneficial impacts on host metabolism and gut barrier function. This study evaluated the association between AM concentration and metabolic markers among patients diagnosed with metabolic dysfunction-associated steatotic liver disease (MASL). The study included a cohort of 122 patients with MASLD, monitored between January 1 and June 30, 2024, at the Venus Vascular Center in Oradea, Romania. Enterotype 2 was predominant in the study population, accounting for over 60% of participants. Correlation analysis revealed no statistically significant association between alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels and AM concentration (ALT: r = -0.147, P = 0.105; AST: r = -0.090, P = 0.325). However, a significant negative linear correlation was determined between gamma-glutamyl transferase (GGT) values and AM concentrations (r = -0.314, P < 0.001) and a moderate, positive correlation between high-density lipoprotein (HDL) values and AM concentration (r = 0.307, P < 0.001). Glycemia showed a weak negative correlation with AM concentration (r = -0.262, P = 0.003). The improvement of liver markers (AST, ALT), even in the absence of correlation with AM concentration, and the negative correlation of GGT, a marker for hepatobiliary diseases and metabolic syndrome, suggest the reduction of oxidative stress in MASLD.