Clients Not Routed Properly with Their IP (GeoIP-based Routing)

We manage the client’s domain and their infrastructure.
The setup:
The DNS is hosted with CloudFlare and CDN (orange cloud icon) is enabled for the DNS record.
When a DNS query hits the CNAME record pointing to Azure Traffic manager, Azure traffic manager is set to route traffic to a region endpoint based on the geographic location of the source IP. (usually an ISP DNS)
There are 2 versions of the site: one is serving US and one is serving Middle East & Europe.
The question
Unfortunately, this setup doesn’t work as expected in a small percentage of the cases. Namely, clients from the Middle East get the US version of the site and vice versa. Assuming the the GeoIP database is correctly updated in Azure and we discarded all the clients using VPNs and other proxies, there are still users who are served with a version of the site not according to their region.
Our question
Could it be that a cache from another region can respond to my query? For example, if I’m located in Israel, can I be served a page from a cache in the US (assuming you have data centers closer to my location)
Could it be that Cloudflare is forwarding the request to another region causing the source IP to change to originate from a different region?

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