I think it is a confusion of the expression "we were born with nothing we die/go out with nothing" and other variations "we were born with nothing we die with nothing, so we might as well +( whatever)" "we were born with nothing we leave with nothing"

Is not a natural sentences, really.. Being alone when you are born or die is not related to what you do in your life. However, the meaning is basically 'your life is yours, so make the most of it' :)

"We're born alone and we'll die alone so we might as well get what we can along the way " Normally when you're born you're a single child/baby in the womb / sac (unless you're born with a twin) and then when you die, you're normally alone in a casket. Hope that helps.

It's a very open sentence (talking about how we understand it), but I always thought that it refers to that what you do in this life, hasn't got a consequence when you die, because.... You'll die alone and with nothing

It mean that doesn't matter what people think about you, because the only important is live your life your way and try to get everything you want.