Are these good for supination?

I both overpronate and over-supinate and these do not help with that, but they are the most comfortable insoles I've ever worn (with plantar fasciitis), regardless. I think stability is something you need to seek in the shoe, first, but supination is tricky because they always recommend regular "neutral" rated shoes and ones that are rated for support or motion control actually cause increased supination. There are some wedge-type partial insoles that cover the heel of the insole of a shoe that I would recommend trying. (Try searching for "supination wedge insole" or something.) You can adjust them so they are pushing your feet inward to favor pronation if that's what you're looking for. I don't think a whole-shoe insole is going to help. Good luck! And if you do find an insole that works for supination, let me know. :)

Can you return these after being trimmed?

I dont know about return policy. You would need to contact the company before purchasing.

Do the sizes correspond to US shoe sizes?

They do . I am a women’s 9.5. I used the conversion chart and got the perfect fit.

What is metatarsalgia, and how can Metatarsalgia Insoles help?

Metatarsalagia is swelling of the Metatarsal, or balls of your feet. It can be caused by continuous running, jumping, or being on your feet. As to how it treats it, simply put, w/o proper support for your feet, you can develop metatarsalagia. Not saying these will stop you from getting it, but it will help with the symptoms if you already have it as per recommended by the Mayo Clinic. These types of inserts have been shown to be effective in treatment

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