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This can create an issue for people with diabetes

Neelakantan and colleagues (Biochem Pharmacol, 2017) then took the pharmacological step, reporting that selective, membrane-permeable small-molecule NNMT inhibitors reversed high-fat-diet-induced obesity in mice this is the study most directly relevant to the 5-Amino-1MQ class, because it moves from the target matters to a drug against the target does something in a live animal. And again, it is a mouse study

Maintaining cellular NAD supports mitochondrial function, stress resilience, and metabolic flexibilitykey mechanisms linking NNMT inhibition to improved energy balance (Kannt & Pfenninger, Frontiers in Physiology )

[8] Similarly, patients with gout or hyperuricemia should avoid high niacin intake, as niacin (even in nicotinamide form) can raise uric acid levels and potentially trigger gout flares