Indeed not always.
To be more in detail for the Mamiya 645 system: The inserts are different, the backs are the same. You can rebuild a 220 insert to 120 insert but you have to adjust the friction then (After removing some parts from the insert itself).
So not a too good idea.
For my Yashica Mat 124G you can switch over the pressure plate to another position.
Indeed 220 roll film has only backing paper in the beginning and at the end.
BTW Foma roll films has been switched from the "lick" glue paper to self adhesive sticker "a la Fuji". They have only 120 roll film assembly and are also doing some 120 roll film assembly for the Rollei-Maco company.
Best regards,
Robert