SMS2 could be a novel regulator of lipid microdomain structure and function. CD36/FAT is located in lipid microdomains. PPARγ is responsible for the expression of CD36/FAT. After HFD feeding, the increased fatty acid or oxLDL would be incorporated via CD36/FAT, activate PPARγ, and induce the hyper-expression of CD36/FAT, resulting in TG accumulation and fatty liver. We found that SMS2 is localized in lipid microdomains and that it associates with CD36/FAT and caveolin 1. Furthermore, we clearly demonstrated that SMS2 could convert Cer to SM on the outer leaflet of the plasma membrane. We conclude that SMS2 could be a novel regulator of lipid microdomain structure and function, and the regulation would be crucial for obesity and type 2 diabetes.