I think a lot of this comes down to what you consider the definition of insanity to be. You could argue that the Joker is very well aware of his actions being unethical, he merely enjoys being bad. Oftentimes insanity is described as the inability to rationally determine what is right and wrong. So you might say that the Joker isn't necessarily insane, at least by that definition, just evil. I always felt that the Joker milked his madness and that it's more so a performance then a legitimate hindrance. He's very competent, genius level so, so much so that he can sometimes accomplish his sadistic goals despite Batman where oftentimes others cannot get one over on the Dark Knight. As they say, there’s a very fine line between brilliance and madness. But you might say that insanity is more so something that disables you or gets in the way, whereas the Joker more so uses his as a tool or means to an end, however illogical or unstable it might be. So in that way, you may say Two-Face would be a very good example as his disorders really hinder him from doing what he sometimes desires, the coin being his direct and only obedience.
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