@Johan Barnard Thanks for sharing the details. I've looked at the logs about this issue and it looks like there is an increase in the number of requests throwing at APIM that might be causing this timeout as the requests are being queued.
When requests arrive from the client to the APIM, they may get queued before they are picked up for processing. The graph above shows the timechart of the maximum size of this queue. we see Persistent incoming request queueing and high CPU utilization this is usually an indication that it is a capacity issue, and it is necessary to scale the service to a larger SKU or to add units.
Reference:
https://blog.leansentry.com/all-about-iis-asp-net-request-queues/
https://learn.microsoft.com/en-us/azure/api-management/api-management-capacity
Hope this clarifies. let me know incase of further questions.