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These use the AdoB 12 (adenosylcobalamin) form of the vitamin

In a trial of patients with T2DM and BMI 27 kg/m2 or more receiving semaglutide injection for weight management, retinal disorders were reported by 6.9% of patients treated with semaglutide 2.4 mg/week, 6.2% of patients treated with semaglutide 1 mg/week, and 4.2% of patients treated with placebo

And if fertility matters to you, the news gets worse

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Yes, it has no hormonal effects of any kind and can be taken by men and women