**Core Concept**
The pathogenesis of alcoholic fatty liver involves the impaired metabolism of fatty acids, leading to their accumulation in hepatocytes. This is primarily due to the inhibition of the enzyme responsible for the breakdown of fatty acids.

**Why the Correct Answer is Right**
The correct answer is related to the inhibition of the enzyme carnitine palmitoyltransferase 1 (CPT1), which is crucial for the transport of long-chain fatty acids into the mitochondria for beta-oxidation. Excessive alcohol consumption leads to the accumulation of acetaldehyde, which in turn inhibits CPT1, resulting in the accumulation of fatty acids in the liver. This impaired fatty acid oxidation leads to the accumulation of triglycerides in hepatocytes, characteristic of alcoholic fatty liver.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not specify the enzyme responsible for the impaired fatty acid metabolism in alcoholic fatty liver.

**Option B:** This option is incorrect because the increased ratio of NADH/NAD+ is related to the impaired beta-oxidation of fatty acids, but it is not the direct cause of the accumulation of fatty acids in the liver.

**Option C:** This option is incorrect because it does not accurately describe the pathogenesis of alcoholic fatty liver.

**Clinical Pearl / High-Yield Fact**
It's essential to remember that the accumulation of fatty acids in the liver in alcoholic fatty liver is due to the inhibition of CPT1, which can be reversed with abstinence from alcohol.

**Correct Answer:** C.