> On the surface, it would be weird for ketones to improve brain activity - after all "keto flu" is a thing, and it is definitely is not a state of high performance.
Keto flu is from a low level of ketones, not a high level. Once enough ketones become available there is no more keto flu. From there most people feel at least normal, and many feel a bit better than normal because the cycles of both energy and satiety are smoothed out by the change in fuel sources.
> And if ketones were that healthy then diabetics would the the healthiest people of all.
Diabetics have health complications precisely because they cannot moderate their blood glucose, with or without ketones. Ketones do not regulate blood glucose, insulin does. Unlike glucose, excess ketones are harmlessly urinated out, they do not need insulin to process them.
Glucose in the blood is toxic [1] if it isn't metabolised because of lack of insulin, and even most diabetics consume enough carbohydrates for this to be a risk. There is a clear relationship between availability of insulin and safe levels of glucose consumption, in fact injecting insulin is usually the first intervention if blood glucose is at dangerously high levels. Search for insulin in that paper.
Ketones don't enter into this picture at all as either a toxin or the solution to toxicity. Precisely the point is that ketones can substitute for most of your glucose needs without risking toxicity like glucose does.
If all of that isn't enough, diabetics often do better following a ketogenic diet [2], not worse. When you can't naturally produce enough insulin to process the glucose you consume for daily energy, producing ketones instead is a safe workaround which your body performs naturally. What part of that is evidence for ketones themselves being the problem?
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738809/
[2] https://pubmed.ncbi.nlm.nih.gov/31336509/