I know several individuals who exercise and are definitely not overweight but are diagnosed with Diabetes II. They have a family history of diabetes which makes me think that people are born with imperfect insulin genes that work in their younger years but as they age they become more damaged as in mutations.
Individuals with family histories of different types of cancer affecting their Mother's, Father's, aunts, grandparents, etc tend to have a higher rate of getting some form of cancer in their 30's usually breast or colon cancer.
This is either genetics or it is directly being caused from their environment.