When you first start up Pokémon Scarlet and Violet, you’ll be given a choice of a look for your character from a list of premade options. These aren’t final selections, though, and they’re more like starting suggestions. This is because you’re also given control over quite a few individual appearance elements as well, some of which are bold and others of which are more subtle. One of the latter, more subtle customizations you can make is a choice of a beauty spot (or two) for your character.
With a total of 14 different beauty spot settings (including no beauty spot,) your options for beauty spots are relatively limited, especially compared to other selections like the wide array of color contact options at your disposal. You can’t choose a color for beauty spots either, just their location (from a few preset locations) and in some cases the locations of two simultaneous beauty spots. With these limitations, it makes sense that these beauty spots are more of a final touch for your overall look, rather than being a centerpiece like your hair or outfit. Note also that some of these beauty spots will not be visible with certain hairstyles.
Like most other appearance settings in Pokémon Scarlet and Violet, you can change your beauty spot selection at any time in the Looks menu (left on the D-pad, followed by +.) Additionally, as with all other appearance settings in the game, none of these beauty spot options are gender-locked.