After naming what looked like an attacking starting XI at the Stadium of Light, the Black Cats registered just two efforts on target in the opening 45 minutes - both of which came on the stroke of half-time.
With his side a goal down at the interval, Neil made even more attacking changes at the break, with Lynden Gooch and Jermain Defoe replacing Corry Evans and centre-back Arbinet Xhemajli.
It also meant a change of shape to a back three, as Sunderland managed to force their way back into the contest before recording a valuable 3-1 win.
The strongest Sunderland XI Alex Neil could pick right now - and the clear transfer priorities it shows
Nine goalkeepers Sunderland could try to sign this summer - including Chelsea youngster, Nottingham Forest stopper and ex-Wolves man
Sunderland transfer news: Black Cats face competition for Derby County playmaker, Cardiff City eye move for former Stoke City loanee
Contract details revealed as Sunderland star Anthony Patterson signs new deal in massive boost
Why Premier League clubs could be more reluctant to sanction loan signings as Sunderland monitor Everton and Tottenham situations
Still, there remains little margin for error if the Black Cats are to finish in the League One play-off places, and they will be expected to take maximum points against bottom of the table Crewe this weekend.
Here are just a few of the selection dilemmas Neil will be considering:
What shape will work best?
In recent fixtures Neil has matched opponents up to yield encouraging performances at Wigan and Charlton.
A 4-2-3-1 system made the Black Cats more compact and resolute against the former, while they still posed an attacking threat.
At Charlton, though, Sunderland dominated the match playing with a back three and wing-backs - a system the Addicks use regularly.
After reverting to a back four against Fleetwood, and then changing things again at half-time, it will be interesting to see how Neil lines his side up this weekend.
There will be an expectation for Sunderland to dominate the ball and attack, yet, as we’ve been reminded at the Stadium of Light in recent months, they can’t leave themselves exposed on the counter attack.
Sunderland are yet to find the right balance in Neil’s three home games so far.
Where will Luke O’Nien fit in?
One player who should bring more stability to the side is midfielder Luke O’Nien.
The 27-year-old certainly made an impressive return after over three months out with a shoulder injury, coming off the bench to score against Fleetwood.
O’Nien’s versatility, energy and leadership qualities are likely to prove valuable for the final nine games, but where exactly will he fit in?
While O’Nien joined Sunderland as a midfielder, he has also played at full-back and even filled in at centre-half last season.
Still, the popular figure appears better suited to playing in the middle of the park, where he can break into the box to provide an extra goal threat.
O’Nien gave a diplomatic answer when asked about his role after the Fleetwood win.
“I think everyone tries to label positions and things like that but listen I’m here to perform, that’s all our jobs to perform,” he said.
Jay Matete has also impressed in midfield since joining the club from Fleetwood, starting every game under Neil. Could the 21-year-old form an effective partnership with O’Nien?
That would probably mean captain Corry Evans drops out of the side, after the Northern Ireland international was substituted at half-time against Fleetwood. He had performed well at Wigan and Charlton but was struggling for form before those fixtures.
There are still likely to be multiple changes between now and the end of the season, while there is also the option to recall Dan Neil.
Could Jermain Defoe start?
If Sunderland do line up with a back three and wing-backs it would allow the side to play with two strikers.
Jermain Defoe came off the bench to play alongside Ross Stewart against Fleetwood, while the pair started the 1-1 with Burton last month.
While Defoe is yet to score for Sunderland in his five appearances since returning to the club, he did play his part in Tuesday’s win.
The striker’s shot from inside the penalty area was blocked before O’Nien converted the chance, while Defoe’s off-the-ball run opened up space for Jack Clarke to score the side’s third.
Neil has mentioned Defoe’s lack of game time on multiple occasions, but the 39-year-old could still be a big asset if he can rediscover that match sharpness.
After Nathan Broadhead missed the Fleetwood game with a minor setback, this could be a chance for Defoe flourish.
Will Callum Doyle be recalled?
At the other end of the pitch teenage defender Callum Doyle is available again.
The Manchester City loanee, 18, hasn’t played in the last three matches due to his heavy workload this campaign.
Xhemajli took Doyle’s place at Wigan and performed well in back-to-back away games.
Still the Kosovan looked rusty against Fleetwood, while it’s easy to forget how little football he’s played given his impressive league debut.
Doyle is clearly a talent with a bright future who can contribute for the final nine fixtures.
His composure on the ball and ability to start attacks from the back was hugely impressive earlier in the season.
Will Nathan Broadhead be risked?
Neil made it clear after the Fleetwood game that he wouldn’t have rested Broadhead if the striker was fit.
After playing 70 minutes at Charlton, the forward felt a tightness in his hamstring and wasn’t included in the squad against Fleetwood.
The Everton loanee is rated very highly by Neil, yet the Sunderland boss won’t want to lose him for another extended period.
You get the impression that if there are any doubts Broadhead won’t be risked at this stage, especially when there are other forward options available.
Still, Sunderland can’t afford to be dropping points against a side languishing at the bottom of the table.
A message from the Football Clubs Editor