The perils of UUID primary keys in SQLite

Using random UUIDs as primary keys in SQLite WITHOUT ROWID tables causes insert performance to degrade by 14-16x compared to sequential integer primary keys, because the random ordering forces constant B-tree rebalancing and excessive disk paging. The performance issue stems from UUIDs' unordered nature causing rows to be inserted randomly into the B-tree structure, requiring frequent tree rebalancing and additional read/write operations that sequential integers avoid.