MTCH1 (mitochondrial carrier 1) is a protein insertase mediating insertion of α-helical transmembrane proteins into the mitochondrial outer membrane (OMM) 1. MTCH1 catalyzes insertion of signal-anchored, tail-anchored, and multipass membrane proteins, but not β-barrel outer membrane proteins 1. The protein functions as a membrane-embedded gatekeeper, controlling protein mislocalization 1. MTCH1 operates as a functional equivalent to the yeast MIM complex, with insertase activity independent of evolutionary relationship to yeast insertases 2. In disease contexts, MTCH1 has emerged as clinically significant. In cervical cancer, MTCH1 governs ferroptosis through retrograde signaling involving the FoxO1-GPX4 axis, with MTCH1 targeting synergizing with Sorafenib to inhibit tumor growth 3. In hepatocellular carcinoma, elevated MTCH1 expression correlates with reduced overall and disease-free survival, implicating involvement in the CDK-RB-E2F signaling axis 4. MTCH1 may play roles in apoptosis regulation 5, with transcriptional regulation by EGR-1 in response to apoptotic stimuli 6. Additionally, autoantibodies against MTCH1 are associated with neuro-Behçet's disease, suggesting autoimmune relevance 7. These findings establish MTCH1 as a potential therapeutic target across multiple malignancies.