Access to high-quality labeled data remains a limiting factor in applied supervised learning. While label variation (LV), i.e., differing labels for the same instance, is common, especially in natural language processing, annotation frameworks often still rest on the assumption of a single ground truth. This overlooks human label variation (HLV), the occurrence of plausible differences in annotations, as an informative signal. Similarly, active learning (AL), a popular approach to optimizing the use of limited annotation budgets in training ML models, often relies on at least one of several simplifying assumptions, which rarely hold in practice when acknowledging HLV. In this paper, we examine foundational assumptions about truth and label nature, highlighting the need to decompose observed LV into signal (e.g., HLV) and noise (e.g., annotation error). We survey how the AL and (H)LV communities have addressed -- or neglected -- these distinctions and propose a conceptual framework for incorporating HLV throughout the AL loop, including instance selection, annotator choice, and label representation. We further discuss the integration of large language models (LLM) as annotators. Our work aims to lay a conceptual foundation for HLV-aware active learning, better reflecting the complexities of real-world annotation.