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Obesity goes hand in hand with hypertension, so this is a double-whammy for organs with particularly sensitive microstructures (like eyes but also kidneys).

Lowering blood sugar below normal levels is hardly unique to semaglutide or GLP1s in general. Most drugs targetting type 2 diabetes can do so and sometimes need to be adjusted to prevent hypoglycemic events. Insulin in particular poses a significant risk of hypoglycemic events which is why many insurances cover continuous glucose monitors for those taking insulin.

GLP1 agonists on its own, has a very low chance of cause significant hypoglycemia because it's action the blood glucose dependent. It almost exclusively happens when patient are taking another agent is taking a diabetic medication that has a proven track record of causing hypoglycemia on it's own