Are things random on a microscopic level? Or just not understood by humans yet?
Random.
You can use the same genetic starting point, but you can't control the micro scale processes that go on autonomously like cells dividing, external environmental conditions, diet, etc. If we could control things like that we could eliminate cancer among other things.
It's kind of like how no two CPUs or no two engines for a car are alike even when they come off the same assembly line back to back, using the same metal from the same batch from the same manufacturer, using the same castings; still going to have random variations since each grain of metal (or silicon) 'behaves' on it's own.
Or similar to nuclear processes like U-235 splitting; it's random and completely spontaneous and unpredictable. In nature you are dealing with probabilities.
And that's just the physical part; obviously the mental side of it, brain neural network creation, personality, etc, are 100% products of environment.