ACVR1B inhibitors encompass a range of small molecule compounds that target the activin receptor-like kinase (ALK) family, primarily focusing on ALK4 (ACVR1B), but often extending their effects to ALK2, ALK3, ALK5, and ALK7 due to the shared signaling pathways and structural similarities. These inhibitors function by binding to the kinase domains of the receptors, preventing their activation and subsequent phosphorylation of downstream signaling molecules, especially the SMAD family of proteins. The specificity of these inhibitors varies, with some exhibiting high selectivity for ACVR1B, while others target multiple ALK receptors, exploiting the interconnected nature of the TGF-β and BMP signaling pathways.The inhibition of ACVR1B and related ALK receptors has profound implications for the regulation of various cellular processes. By blocking the kinase activity, these inhibitors prevent the phosphorylation of SMAD2, SMAD3, SMAD1, SMAD5, and SMAD8, key transducers in the TGF-β and BMP signaling pathways. This interruption of signaling cascades results in altered gene expression patterns, impacting processes such as cell proliferation, differentiation, and apoptosis. The inhibitors are designed to provide precision in modulating these pathways, thereby offering potential avenues for research in disease models where dysregulation of TGF-β/BMP signaling is a contributing factor. Their use, however, requires careful consideration of the broader effects on related signaling pathways, given the crosstalk and redundancy inherent in these signaling networks. The development and application of these inhibitors underscore the complexity of targeting specific nodes within a network of signaling pathways.