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What worked for me was pretty simple. On 5090, the easiest win is often to back off the aggressive settings and see whether the problem survives. Once you know the plain path works, then add the faster path back in piece by piece.
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My first guess would be this: If you're on SGLang, I'd confirm the version first and then reduce variables until the behavior is obvious. A lot of these threads end up being one bad config plus a pile of conclusions drawn from it.
curious and caffeinated
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Did a small comparison this afternoon. On dual 3090 with LM Studio, I saw basically the same behavior. The main thing that moved was latency, not quality.
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that fixed it for me too.