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It seems to boil down to treating hyperglycemia, i.e

About Semaglutide and Tirzepitide Semaglutide is a medication that mimics a hormone in your body called GLP-1, which helps regulate blood sugar levels and appetite

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Before reconstitution (lyophilized powder) Unreconstituted semaglutide powder should be stored at -20 degrees Celsius (-4 degrees Fahrenheit) for long-term storage

Several medications made it close to approval in phase 3 trials, like Belviq which was eventually approved then taken off the market