Declining a medical school acceptance being a big red flag is definitely a thing. I didn't know about it, but it's there. Look it up. There are lots of threads where adcoms say it's definitely an issue.
Reasonably speaking, motivation to attend medical school is the most important factor in the application process. Medical schools, however, rarely have any objective evidence to call your motivation into question so the factor rarely comes into play. The PS, secondaries, and interviews are all subjectively judged. However, if you decline your acceptance(s), it will show up on your record as objective evidence (your AAMC application will indicate you declined an acceptance) calling into question your motivation.
While you haven't committed a crime by any means, it's analogous IN THE SENSE that it will be a significant question/red flag on your record and you will have to provide a very solid explanation to counter that. Also, like a crime, you'll find people who got in regardless...but that doesn't mean you should take that risk.
My advice is that if you plan to spend a large part of your life practicing medicine, take the MD acceptance NOW, worry about the MBA later. You can always do an MBA within medical school, or within residency.
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Accepted but Declining: Good or Bad? Help!
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