Another ditto for Celerystalksme.
Just yesterday I was just at the foot/ankle specialist who wants me fitted with custom orthotics.

I specifically asked him if I should wear these inside cycling shoes, thinking that not wearing them would undo any benifit from wearing them in regular shoes.

He told me it's not necessary as you aren't weight bearing while cycling. Also said most cycling shoes are too narrow to fit them anyway.

I'm inclined to think hot spots would be more due to cleat placement or platform size.