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It is possible the human trials never delivered enough intact peptide to the relevant tissue to reproduce the rodent effect, though this remains a hypothesis rather than a demonstrated cause of failure

Strongest human evidence The METAOD006 (OPTIONS) Phase 2b trial randomized 502 adults with obesity (BMI 30-45 kg/m^2) to oral AOD-9604 (0.25, 0.5, or 1 mg/day) or placebo for 24 weeks alongside a supervised diet and exercise program

AOD 9604 10mg and Mixing Water 3ml (2% Acetic Acid) A sterile reconstitution solution containing 2% acetic acid AOD 9604 is a synthetic peptide fragment of human growth hormone (hGH, residues 177-191), extensively researched for fat metabolism, lipolysis, and weight regulation in preclinical models

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Essentially the injection may be a temporary measure to fix levels

Effects of Tesamorelin on non-alcoholic fatty liver disease in HIV: a randomized, double-blind, multicentre trial