Had a cleat assessment a while ago and it turned out my knees were massively offline compared to my ankles, to the extent that I was advised to go and see a podiatrist. Turns out I have a forefoot varus angle of 4degrees which was causing my knees to move inward under pressure. He stuck a wedge underneath my insoles which has straightened out the alignment. The problem is because it’s raised my forefoot a bit my heel feels loose in the shoes. I think it’s partly because spd shoes are narrow and so there isn’t much space. I’m getting a bit of knee pain that may or may not be related.

Anyone else have issues with forefoot angle and alignment? Any recommended orthotics that fit well in spd shoes?

What about heat molded insoles that you warm up in the oven then put in your shoes.. I have several pairs of soletec ones but specialized make them too.

Depends if they offer enough support to correct your issue

I would go back to the podiatrist or speak to a podiatrist who does lots of cycling stuff. I’ve had similar issues.