I had an overweight BMI when I could run a sub 3-hour marathon, I’ve concluded my body just doesn’t match the normal range.
Another point is that you can be good athletically speaking and yet have too much body fat to be considered healthy. An extreme example is that of professional fighters in open-weight categories.
It's not A1C or something that's actively tracking your success and management in the long term, it's just the kind of thing where you look at it, look at the person, and say "is this a problem?" and usually it's clear.