In real-life, a ferry carries travelers from Barcelona to Mazara del Vallo in Italy, but this is not included in-game, with the closest equivalent being the ferry to Palermo.
In real-life, the route jumps acrosss the Strait of Messina onto the Italian mainland south of Villa San Giovanni, following the southern coast of Italy. The E90 is not rendered until further north with the SS106.
In real-life, the E90 continues further southeast to the Italian city of Brindisi, where a ferry then leads to Greece. From there, the route continues across northern Greece and through Turkey.