Analysis of 7,619 East Asian genomes identified nearly 29,000 novel methylation quantitative trait loci (mQTLs) that regulate DNA methylation patterns differently than in European populations. These population-specific epigenetic regulators show strong enrichment for disease heritability markers, indicating that genetic ancestry influences how environmental factors get translated into disease risk through methylation changes. This discovery challenges the prevailing assumption that epigenetic regulation follows universal patterns across human populations. The findings have profound implications for precision medicine, particularly for diseases with known population disparities like diabetes, cardiovascular disease, and certain cancers. Many current therapeutic targets and biomarkers were identified in European cohorts, potentially missing critical regulatory pathways active in other populations. The methylation differences may explain why some treatments show variable efficacy across ethnic groups and why disease prevalence varies dramatically between populations even when environmental exposures are similar. However, the study's observational design cannot establish whether these methylation patterns directly cause disease differences or merely correlate with other causal factors. Replication in additional populations and functional validation of key mQTLs will be essential to translate these insights into clinical applications.