It's easier to buy and sell leveraged tokens with an AMM or on an exchange because there's no minimum amount that traders need to buy or sell and they don't need to wait to trade. For this reason, most token trading activity will happen on secondary markets. Traders can mint leveraged tokens from a pool and provide them as secondary market liquidity to earn swap fees or profit from order book spread.
Because tokens can be burned back into a Perpetual Pool for collateral, tokens should trade at a price close to what is quoted by the pool. If there is a difference between the pool price and the market price, traders (arbitrageurs) will take advantage of the difference to make a profit. This kind of trading activity will drive token prices towards the fair value.
If there is collateral skew in a pool, traders can construct a profitable risk-less portfolio by holding a position in the underlying asset and a position in the pool. The pool position is held in the side with less demand because this position has an asymmetric upside. Delta neutral portfolios of this nature are constructed with equal notional value of spot and leveraged tokens. An anticipated positive rebalancing rate suggests that such a portfolio would hold spot long and pool short (S-tokens).