diff --git a/src/components/insights/__tests__/insights-edit-mode-manager.test.tsx b/src/components/insights/__tests__/insights-edit-mode-manager.test.tsx
index d39d4fad5..0b4a4d599 100644
--- a/src/components/insights/__tests__/insights-edit-mode-manager.test.tsx
+++ b/src/components/insights/__tests__/insights-edit-mode-manager.test.tsx
@@ -60,4 +60,26 @@ describe("<InsightsEditMode> — detail-page manager retired (v1.15.20)", () =>
     expect(html).toContain('data-slot="insights-edit-section-row"');
     expect(html).toContain('data-slot="insights-edit-section-eye"');
   });
+
+  it("as a Settings card: settings header, one action row last, no self-link", () => {
+    // On /settings/layout/insights the editor is a standing card. The
+    // pointer "Manage chips in Settings" would link to the page it is on,
+    // and Reset + Done beside the title broke the one-action-row rule.
+    const html = render(
+      <InsightsEditMode
+        variant="settings"
+        layout={DEFAULT_INSIGHTS_LAYOUT}
+        gatedOffSectionIds={noneGated}
+        onClose={() => {}}
+      />,
+    );
+    expect(html).not.toContain('data-slot="insights-edit-manage-link"');
+    expect(html).toContain('id="insights-overview-arrange-title"');
+    const row = html.indexOf('data-slot="settings-card-actions"');
+    expect(row).toBeGreaterThan(
+      html.lastIndexOf('data-slot="insights-edit-section-row"'),
+    );
+    expect(html.slice(row)).toContain('data-slot="insights-edit-done"');
+    expect(html.slice(row)).toContain(">Save</button>");
+  });
 });
diff --git a/src/components/insights/insights-edit-mode.tsx b/src/components/insights/insights-edit-mode.tsx
index e16191a35..7ccf96c92 100644
--- a/src/components/insights/insights-edit-mode.tsx
+++ b/src/components/insights/insights-edit-mode.tsx
@@ -4,7 +4,14 @@ import { useEffect, useMemo, useRef, useState } from "react";
 import Link from "next/link";
 import { useMutation, useQueryClient } from "@tanstack/react-query";
 import { toast } from "sonner";
-import { Eye, EyeOff, GripVertical, Loader2, RotateCcw } from "lucide-react";
+import {
+  Eye,
+  EyeOff,
+  GripVertical,
+  LayoutGrid,
+  Loader2,
+  RotateCcw,
+} from "lucide-react";
 import {
   DndContext,
   KeyboardSensor,
@@ -24,6 +31,8 @@ import { CSS } from "@dnd-kit/utilities";
 
 import { Button } from "@/components/ui/button";
 import { SettingsCard } from "@/components/settings/settings-card";
+import { SettingsCardActions } from "@/components/settings/_card-actions";
+import { SettingsCardHeader } from "@/components/settings/_card-header";
 import { ConfirmButton } from "@/components/ui/confirm-button";
 import { cn } from "@/lib/utils";
 import { prefersReducedMotion } from "@/lib/charts/reduced-motion";
@@ -88,13 +97,24 @@ interface InsightsEditModeProps {
   gatedOffSectionIds: ReadonlySet<InsightsSectionId>;
   /** Close edit mode (the "Fertig" / save-success path calls this). */
   onClose: () => void;
+  /**
+   * `page` (default) is the inline editor the Insights overview opens: its own
+   * title, Reset + Done beside it, and a pointer to the Settings pill manager.
+   * `settings` is the same editor as a standing Settings card: a settings
+   * header, the actions in one row at the bottom (design standards §12), no
+   * pointer back to the page it already sits on, and no focus grab on mount —
+   * the card is part of the page, not a surface the user just opened.
+   */
+  variant?: "page" | "settings";
 }
 
 export function InsightsEditMode({
   layout,
   gatedOffSectionIds,
   onClose,
+  variant = "page",
 }: InsightsEditModeProps) {
+  const inSettings = variant === "settings";
   const { t } = useTranslations();
   const queryClient = useQueryClient();
 
@@ -115,8 +135,9 @@ export function InsightsEditMode({
   // "Anpassen" toggle on close via the page's onClose handler.
   const headingRef = useRef<HTMLHeadingElement | null>(null);
   useEffect(() => {
+    if (inSettings) return;
     headingRef.current?.focus();
-  }, []);
+  }, [inSettings]);
 
   const sensors = useSensors(
     useSensor(PointerSensor, { activationConstraint: { distance: 6 } }),
@@ -186,6 +207,15 @@ export function InsightsEditMode({
   });
 
   const busy = saveMutation.isPending || resetMutation.isPending;
+  // The Settings card's Save waits for a change, like the pill-order Save
+  // beside it; the overview's inline editor keeps "Done" live because it
+  // also closes the editor.
+  const arrangement = (rows: readonly InsightsSectionConfig[]) =>
+    [...rows]
+      .sort((a, b) => a.order - b.order)
+      .map((r) => `${r.id}:${r.visible ? 1 : 0}`)
+      .join(",");
+  const dirty = arrangement(draft.sections) !== arrangement(layout.sections);
 
   const sections = useMemo(
     () => [...draft.sections].sort((a, b) => a.order - b.order),
@@ -215,46 +245,55 @@ export function InsightsEditMode({
 
   return (
     <SettingsCard data-slot="insights-edit-mode">
-      <div className="flex flex-col gap-2 sm:flex-row sm:items-center sm:justify-between sm:gap-3">
-        <div>
-          <h2
-            ref={headingRef}
-            tabIndex={-1}
-            className="text-lg font-semibold focus-visible:outline-none"
-          >
-            {t("insights.editMode.title")}
-          </h2>
-          <p className="text-muted-foreground text-sm">
-            {t("insights.editMode.description")}
-          </p>
+      {inSettings ? (
+        <SettingsCardHeader
+          icon={LayoutGrid}
+          title={t("insights.settings.overviewTitle")}
+          titleId="insights-overview-arrange-title"
+          description={t("insights.settings.overviewDescription")}
+        />
+      ) : (
+        <div className="flex flex-col gap-2 sm:flex-row sm:items-center sm:justify-between sm:gap-3">
+          <div>
+            <h2
+              ref={headingRef}
+              tabIndex={-1}
+              className="text-lg font-semibold focus-visible:outline-none"
+            >
+              {t("insights.editMode.title")}
+            </h2>
+            <p className="text-muted-foreground text-sm">
+              {t("insights.editMode.description")}
+            </p>
+          </div>
+          <div className="flex items-center gap-2 self-end sm:self-auto">
+            <ConfirmButton
+              slot="insights-edit-reset"
+              variant="ghost"
+              size="sm"
+              icon={<RotateCcw className="h-3.5 w-3.5" />}
+              label={t("insights.editMode.reset")}
+              title={t("insights.editMode.resetTitle")}
+              body={t("insights.editMode.resetBody")}
+              confirmLabel={t("insights.editMode.resetConfirm")}
+              disabled={busy && !resetMutation.isPending}
+              pending={resetMutation.isPending}
+              onConfirm={() => resetMutation.mutate()}
+            />
+            <Button
+              size="sm"
+              onClick={() => saveMutation.mutate(draft)}
+              disabled={busy}
+              data-slot="insights-edit-done"
+            >
+              {saveMutation.isPending && (
+                <Loader2 className="h-3.5 w-3.5 animate-spin motion-reduce:animate-none" />
+              )}
+              {t("insights.editMode.done")}
+            </Button>
+          </div>
         </div>
-        <div className="flex items-center gap-2 self-end sm:self-auto">
-          <ConfirmButton
-            slot="insights-edit-reset"
-            variant="ghost"
-            size="sm"
-            icon={<RotateCcw className="h-3.5 w-3.5" />}
-            label={t("insights.editMode.reset")}
-            title={t("insights.editMode.resetTitle")}
-            body={t("insights.editMode.resetBody")}
-            confirmLabel={t("insights.editMode.resetConfirm")}
-            disabled={busy && !resetMutation.isPending}
-            pending={resetMutation.isPending}
-            onConfirm={() => resetMutation.mutate()}
-          />
-          <Button
-            size="sm"
-            onClick={() => saveMutation.mutate(draft)}
-            disabled={busy}
-            data-slot="insights-edit-done"
-          >
-            {saveMutation.isPending && (
-              <Loader2 className="h-3.5 w-3.5 animate-spin motion-reduce:animate-none" />
-            )}
-            {t("insights.editMode.done")}
-          </Button>
-        </div>
-      </div>
+      )}
 
       {allHidden && (
         <p
@@ -298,18 +337,49 @@ export function InsightsEditMode({
         </SortableContext>
       </DndContext>
 
-      {/* v1.15.20 — the per-detail-page manager (sort + show/hide) lives on
-          Settings → Insights; the disclosure this card used to nest under
-          the Vitals row duplicated it. Keep a quiet pointer instead. */}
-      <p className="text-muted-foreground text-xs">
-        <Link
-          href="/settings/layout/insights#insights-pill-order"
-          data-slot="insights-edit-manage-link"
-          className="hover:text-foreground focus-visible:ring-ring rounded underline underline-offset-2 focus-visible:ring-2 focus-visible:outline-none"
-        >
-          {t("insights.editMode.manageInSettings")}
-        </Link>
-      </p>
+      {inSettings ? (
+        <SettingsCardActions>
+          <ConfirmButton
+            slot="insights-edit-reset"
+            variant="outline"
+            size="sm"
+            className="min-h-11 sm:min-h-9"
+            icon={<RotateCcw className="h-3.5 w-3.5" />}
+            label={t("insights.editMode.reset")}
+            title={t("insights.editMode.resetTitle")}
+            body={t("insights.editMode.resetBody")}
+            confirmLabel={t("insights.editMode.resetConfirm")}
+            disabled={busy && !resetMutation.isPending}
+            pending={resetMutation.isPending}
+            onConfirm={() => resetMutation.mutate()}
+          />
+          <Button
+            size="sm"
+            className="min-h-11 sm:min-h-9"
+            onClick={() => saveMutation.mutate(draft)}
+            disabled={busy || !dirty}
+            data-slot="insights-edit-done"
+          >
+            {saveMutation.isPending && (
+              <Loader2 className="h-3.5 w-3.5 animate-spin motion-reduce:animate-none" />
+            )}
+            {t("common.save")}
+          </Button>
+        </SettingsCardActions>
+      ) : (
+        // v1.15.20 — the per-detail-page manager (sort + show/hide) lives on
+        // Settings → Insights; the disclosure this card used to nest under
+        // the Vitals row duplicated it. Keep a quiet pointer instead.
+        <p className="text-muted-foreground text-xs">
+          <Link
+            href="/settings/layout/insights#insights-pill-order"
+            data-slot="insights-edit-manage-link"
+            className="hover:text-foreground focus-visible:ring-ring rounded underline underline-offset-2 focus-visible:ring-2 focus-visible:outline-none"
+          >
+            {t("insights.editMode.manageInSettings")}
+          </Link>
+        </p>
+      )}
     </SettingsCard>
   );
 }
diff --git a/src/components/settings/__tests__/medications-section.test.tsx b/src/components/settings/__tests__/medications-section.test.tsx
index f44a9f36d..8704f98e9 100644
--- a/src/components/settings/__tests__/medications-section.test.tsx
+++ b/src/components/settings/__tests__/medications-section.test.tsx
@@ -97,7 +97,8 @@ describe("<MedicationsSection> — SSR smoke", () => {
 
   it("renders the German copy end-to-end", () => {
     const html = render("de");
-    expect(html).toContain("Reihenfolge anpassen");
+    // The order card shares its title with the Labs order card.
+    expect(html).toContain(">Reihenfolge<");
     expect(html).toContain(
       "Wähle, ob deine Medikamente als Karten oder als Tabelle angezeigt werden.",
     );
diff --git a/src/components/settings/documents-section.tsx b/src/components/settings/documents-section.tsx
index f1e9b4f12..35f60b49b 100644
--- a/src/components/settings/documents-section.tsx
+++ b/src/components/settings/documents-section.tsx
@@ -9,7 +9,7 @@
  * shape): the card/list view and the month arrangement. Both persist per user
  * through `/api/documents/inbound/layout`.
  */
-import { Eye, Rows3, WrapText } from "lucide-react";
+import { LayoutGrid, Rows3, WrapText } from "lucide-react";
 
 import { SettingsCardHeader } from "@/components/settings/_card-header";
 import { SettingsCard } from "@/components/settings/settings-card";
@@ -26,7 +26,7 @@ export function DocumentsSection() {
     <div className="space-y-6" data-slot="documents-layout-settings">
       <SettingsCard id="documents-view" className="scroll-mt-28">
         <SettingsCardHeader
-          icon={Eye}
+          icon={LayoutGrid}
           title={t("moduleList.viewHeading")}
           description={t("documents.layout.viewDescription")}
           status={<ModuleViewToggle view={layout.view} onChange={setView} />}
diff --git a/src/components/settings/insights-overview-arrange-section.tsx b/src/components/settings/insights-overview-arrange-section.tsx
index 5acb424cb..5ed574433 100644
--- a/src/components/settings/insights-overview-arrange-section.tsx
+++ b/src/components/settings/insights-overview-arrange-section.tsx
@@ -9,8 +9,8 @@ import { useAuth } from "@/hooks/use-auth";
 import { useAiCapability } from "@/hooks/use-ai-capability";
 import { useInsightsLayoutQuery } from "@/hooks/use-insights-layout";
 import { InsightsEditMode } from "@/components/insights/insights-edit-mode";
-import { SectionHeading } from "@/components/ui/section-heading";
 import { SettingsCard } from "@/components/settings/settings-card";
+import { SettingsCardHeader } from "@/components/settings/_card-header";
 import {
   INSIGHTS_SECTION_IDS,
   type InsightsSectionId,
@@ -59,29 +59,28 @@ export function InsightsOverviewArrangeSection({ id }: { id?: string }) {
       id={id}
       data-slot="insights-overview-arrange-section"
       aria-labelledby="insights-overview-arrange-title"
-      className="space-y-3"
+      className="scroll-mt-28"
     >
-      <SectionHeading
-        icon={LayoutGrid}
-        id="insights-overview-arrange-title"
-        title={t("insights.settings.overviewTitle")}
-        subtitle={t("insights.settings.overviewDescription")}
-      />
-
       {/* Gate the editor mount until the layout GET settles. The editor seeds
           its draft once from `layout` on mount, which is the canonical default
-          while in flight; mounting it early would let a "Fertig" save flush
-          defaults over the user's real saved layout (the same QA-L1 gate the
-          mother page applies to its "Anpassen" toggle). */}
+          while in flight; mounting it early would let a Save flush defaults
+          over the user's real saved layout (the same QA-L1 gate the mother
+          page applies to its "Anpassen" toggle). The loading card paints the
+          same header the loaded card carries (design standards §13), so the
+          page does not reflow under the cursor when the list arrives. */}
       {isLoading ? (
-        <SettingsCard
-          className="text-muted-foreground flex items-center gap-2 text-sm"
-          data-slot="insights-overview-arrange-loading"
-        >
-          <Loader2 className="h-4 w-4 animate-spin motion-reduce:animate-none" />
+        <SettingsCard data-slot="insights-overview-arrange-loading">
+          <SettingsCardHeader
+            icon={LayoutGrid}
+            title={t("insights.settings.overviewTitle")}
+            titleId="insights-overview-arrange-title"
+            description={t("insights.settings.overviewDescription")}
+          />
+          <Loader2 className="text-muted-foreground h-4 w-4 animate-spin motion-reduce:animate-none" />
         </SettingsCard>
       ) : (
         <InsightsEditMode
+          variant="settings"
           layout={layout}
           gatedOffSectionIds={gatedOffSectionIds}
           onClose={() => {}}
diff --git a/src/components/settings/medications-section.tsx b/src/components/settings/medications-section.tsx
index 6fc8ec40f..d02f97ed4 100644
--- a/src/components/settings/medications-section.tsx
+++ b/src/components/settings/medications-section.tsx
@@ -1,7 +1,7 @@
 "use client";
 
 import { useQuery } from "@tanstack/react-query";
-import { LayoutGrid, Loader2, Pill } from "lucide-react";
+import { LayoutGrid, ListOrdered } from "lucide-react";
 
 import {
   MedicationOrderEditor,
@@ -9,6 +9,7 @@ import {
 } from "@/components/medications/medication-order-editor";
 import { MedicationViewToggle } from "@/components/medications/medication-view-toggle";
 import { SettingsCard } from "@/components/settings/settings-card";
+import { Skeleton } from "@/components/ui/skeleton";
 import { SettingsCardHeader } from "@/components/settings/_card-header";
 import { InjectionSitesCard } from "@/components/settings/injection-sites-card";
 import { useAuth } from "@/hooks/use-auth";
@@ -81,33 +82,39 @@ export function MedicationsSection() {
       {/* View preference — cards vs table. The shared header toggle
           writes optimistically, so there is no Save button here. */}
       <SettingsCard id="medications-view" className="scroll-mt-28">
+        {/* Same shape as the Labs and Documents view cards: the hint is the
+            header description, the toggle sits in the status slot. */}
         <SettingsCardHeader
           icon={LayoutGrid}
           title={t("medications.viewToggleLabel")}
-        />
-        <div className="border-border bg-background/30 flex min-h-12 items-center justify-between gap-3 rounded-md border px-3 py-2">
-          <p className="text-muted-foreground min-w-0 text-xs">
-            {t("medications.viewToggleHint")}
-          </p>
-          {isLayoutLoading ? (
-            <Loader2 className="text-muted-foreground h-4 w-4 animate-spin motion-reduce:animate-none" />
-          ) : (
+          description={t("medications.viewToggleHint")}
+          status={
+            // Painted from the first frame, like the Labs and Documents
+            // toggles: a spinner the width of one icon swapped for a
+            // two-button toggle moved the cards below it.
             <MedicationViewToggle view={layout.view} onChange={setView} />
-          )}
-        </div>
+          }
+        />
       </SettingsCard>
 
       {/* Manual order — applies to both list views. */}
       <SettingsCard id="medications-order" className="scroll-mt-28">
         <SettingsCardHeader
-          icon={Pill}
-          title={t("medications.reorderTitle")}
+          icon={ListOrdered}
+          title={t("moduleList.reorder.heading")}
           description={t("medications.reorderDescription")}
         />
         {isLoading || isLayoutLoading ? (
-          <div className="text-muted-foreground flex items-center gap-2 text-sm">
-            <Loader2 className="h-4 w-4 animate-spin motion-reduce:animate-none" />
-            {t("common.loading")}
+          // Row-shaped placeholders instead of a one-line spinner, so the
+          // card below moves less when the list arrives.
+          <div
+            className="space-y-2"
+            role="status"
+            aria-label={t("common.loading")}
+          >
+            {Array.from({ length: 3 }, (_, i) => (
+              <Skeleton key={i} className="h-14 w-full rounded-md" />
+            ))}
           </div>
         ) : (
           <MedicationOrderEditor medications={ordered} />