Probably both - however I think it's not unreasonable to assume that organizations as mentioned in the article at least have the Chinese government's blessing, if they're not directly controlled by it. So even if the fentanyl itself is not coming from outside the states, the precursors from which it can be made with little effort are.

That and I guess some gangs make it somewhere else and then import it, but that's another story.

Also technically, I think there's legal fentanyl being produced in the states, but that's usually not what's meant in the discussion.