NADH utilization refers to the process by which the reduced form of nicotinamide adenine dinucleotide (NADH) is used in metabolic pathways, particularly in gluconeogenesis where it serves as a key electron donor. This process is crucial for the conversion of pyruvate to glucose, especially during periods when glucose levels are low. The effective use of NADH is vital for energy production and maintaining cellular redox balance during gluconeogenesis.