ADHD stimulants appear to work less by sharpening focus and more by waking up the brain. Brain scans revealed that these medications activate reward and alertness systems, helping children stay interested in tasks they would normally avoid. The drugs even reversed brain patterns linked to sleep deprivation. Researchers say this could complicate ADHD diagnoses if poor sleep is the real underlying problem.
edit here is another article
https://medicine.washu.edu/news/stimulant-adhd-medications-work-differently-than-thought/



This lines up with my experience more. I never identified well with “you need help focusing, this medication does that and that’s why it helps you”. I have always been able to sit for half a dozen hours on an interesting thing and completely forget to eat or think about anything else. So it doesn’t make much sense to me that I have a focusing issue. I had been explaining my medication as “it takes the minimum level of reward the thing has to provide me for me to continue doing it, and drops it into the floor. So now everything is so rewarding that it doesn’t matter what it is, I can focus like I did with only a few things before”.