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Oral melanocytic pigmentation in Caucasians is almost always considered pathologic in origin, although the pathology or pigment itself may be of no clinical significance

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Hickson RP et al (2019): Implications of Removing Rosiglitazones Black Box Warning and Restricted Access Program on the Uptake of Thiazolidinediones and Dipeptidyl Peptidase-4 Inhibitors Among Patients with Type 2 Diabetes

This is why an oral B12 supplement might do nothing for your fatigue, but a B12 injection makes you feel different by that afternoon

The 2.58 percent HbA1c reduction seen at higher doses represents a clinical effect comparable to two or three additional antidiabetic medications