It seems to span the full spread of social awkwardness - all the way from just being weird, down to being a jerk. I've seen people who are jerks not because they want to be, but because they can't help but run their mouth when they're in the wrong emotional state. I've also had at least one friend who'd frequently do really rude things like suddenly walking away mid-conversation, and it wasn't because he wanted to insult us, but it was because his ADHD was redlining so badly that he had to seek any other available stimulation, even if there wasn't any available.
At this point, I'm honestly convinced most human malfeasance is just manifestations of various mental illnesses, and I really wish we'd approach it with a therapeutic, rather than punitive, approach. We might actually fix things, if we did.
I really wish society had more sympathy for people who don't fit in socially. With all the progress we are tying make not demeaning people for their race or sexuality it still seems OK to bash socially awkward people.