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However, with todays hygiene standards for food products, most people do not ingest trace amounts of soil with their fruits and vegetables, and therefore no B12

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New England Journal of Medicine , 375(19), 18341844

This is perhaps because skin cancers can come from skin cells anywhere in the body and not just on the birthmark itself

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Coskun and Urva (2022, pharmacological description) describe the engineering: modified sequence derived from native GIP, Aib2 and Aib13 substitutions resisting DPP-4, and a C20 diacid fatty-acyl chain grafted to a lysine via a gamma-glutamate linker to extend half-life to approximately 6 days