Skinwalkers are often confused at first.

Many sharing their bodies with another are understandably confused and concerned. They can feel the other presence in their mind, but how can they explain that to anyone without being labeled a nut? Then they wonder if they really are crazy and delusional.
Some of them actually do go crazy at the dilemma this puts them in. Strange murders and inexplicable suicides can result for those poor souls.
No human brain is exactly the same as anyone else;s. Individual variations exist as a natural process of heredity, environment and diet. Bob's brain is different from Nick's which is different from Sue's and Ann's, etc., ibid 7 or 8 billion times. It seems implanting a second consciousness is kind of an art form. Although it sometimes goes very smoothly, sometimes errors are made and the 2nd consciousness acquires more dominance than the body the brain controls can handle.
Hallmarks of a botched implantation require alertness and maybe even some training to spot. Although myths of such possessions go back thousands of years and have a dozen or more names in human history (possessed, skin walker, shape shifter, paranoid schizophrenia, etc) most of human society is not alert to the phenomena.
A popular target of such implantation are leaders and what are today called influencers. Radio announcers, TV and movie stars and religious leaders were frequent targets in the past.
Things observers should be alert for as evidence someone may be have experienced a botched implantation could be someone previously physically fit and well coordinated suddenly tripping on stairs or failing at simple routine physical tasks such as dropping a coffee cup, or missing the mouth while trying to take a drink putting shoes on the wrong foot, etc. This is because the one in charge or trying to be in charge of the possessed person is not the one the body normally resounds to. Another symptom is when talking or doing something, suddenly the person will just freeze, unable to respond to questions or voice anything, or even to move. This reflects an internal struggle in their brain to take back control. However, even if briefly successful after a moment of struggle, in human society today, very few would believe them, so they will insist everything is alright and nothing is going on, while bystanders may wonder if they just witnessed a minor stroke. Sometimes an implant gone wrong will in time cause actual brain damage and someone previously normal may suddenly start speaking incomprehensible word salad, or suddenly manifest strange conspiracy beliefs, etc. If they suddenly claim someone is in their head and it hurts, it may be too late to help them and they usually die of brain hemorrhage soon after.
Some skin walkers were / are people of no great importance or known significance, but the hitchhiker entity has picked them for a reason that may take years to become clear. It is possible the entities doing the possessions can see alternate history paths and forks in future timelines in which this or that person can with a little push play a major role.
It has been alleged that sometimes the 2nd consciousness shares information, suddenly the host knows a 2nd lir 3rd language without study, or announces and makes new inventions or ways of doing things no one else had thought of. They may claim to have had conversations no one else could hear with Angels or Demons. This may be an opportunity for an observer recognizing the symptoms to provide help and ask some questions of the other entity in their head.
The end goal of those doing the implanting of a 2nd consciousness in so many humans is not yet known, but it may not be a good one for humanity.