In essence, M2 macrophages are shown to share similar attributes to that of proinflammatory and tumor-associated macrophages . A view on the role of extracellular lactate as a metabolic fuel by microbiotas is proposed. In this way, an indirect role of lactylation in cancer growth and proliferation is proposed by activating M1 macrophages in the tumor microenvironment which is in turn transformed into pro-tumor M2 macrophages . Among many distinctive features of M1 macrophages, acetyl-CoA synthetase is highly active and overexpressed which is known to catalyze the formation of acetyl-CoA from acetate .