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The metadata transformation will validate if any answers are duplicated within a question. Note the behavior is different when you made changes:
If you didn't touch the answer block at all, Forsta Visualizations will accept the duplicate and add a suffix to the label {nr}.So if you import question Country:
1: Sweden
2: Germany
3: Sweden
This will be accepted and imported as:
1: Sweden {1}
2: Germany
3: Sweden {2}
However, once you touch this answer group and adjust a label, this it will not add any suffix, and it will be blocked because of this duplicate. For example, you are adding an answer Belgium:
1: Sweden
2: Germany
3: Sweden
4: Belgium
You use the MDT to adjust this label for Belgium because it was cut off, so it becomes:
1: Sweden
2: Germany
3: Sweden
4: Belgium
And now Forsta Visualizations will not add the suffix anymore, and your import will throw an error because Sweden is in there twice.