Eating 3 balanced meals throughout the day might be marginally better or worse for the pancreas, but neither of these dietary choices trigger the panic-level insulin responses (which ultimately lead to insulin resistance and diabetes) that snacking on large amounts of refined carbs and refined sugars are notorious for.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2121099/ This study found that although there was higher blood glucose and reduced glucose tolerance in the morning for the group eating 1 meal a day, surprisingly they had less insulin resistance than the group eating 3. Other indicators of dietary/hormonal health were the same between groups. Same caloric intake of glucose between groups, and the 1 meal a day group shared the same evening window just like OMAD. This was a pilot study with small sample size (irritatingly the actual number isn't listed from what I can see) as well as a high withdrawal rate, unsurprisingly.
I note with interest that we make reference to insulin "spikes".
Do I want to insulin spike more, or fewer, times per day ?