With changes of human disease spectrum，obesity and its complications have become important health risk factors. Under normal physiological conditions，there is a certain amount of lipid droplets in skeletal muscle，known as intramuscular fat. However， when the body becomes obese，the rate of lipid droplet generation exceeds consumption，leading to the overload of adipose tissue and resulting in ectopic fat deposition. This excessive accumulation of intramuscular fat severely disrupts the normal function of skeletal muscle and plays an important role in the occurrence and development of sarcopenia，obesity and diabetes. Although the importance of intramuscular fat infiltration in obesity and related metabolic diseases is widely recognized，its specific regulatory mechanism remains unclear. Therefore，exploring new strategies and methods to improve intramuscular fat infiltration not only helps us to better understand the pathogenesis of these diseases but also provide new perspectives for the treatment of these diseases. The core content of this article lies in comprehensively elucidating the physiological functions of intramuscular fat tissue and the mechanisms leading to intramuscular fat infiltration under pathological conditions. Additionally，the research progress on the intervention for intramuscular fat infiltration is reviewed，aiming to provide potential therapeutic strategies for the treatment of clinical diseases related to intramuscular fat infiltration.