I had the same task - get the image from MSSQL DB. And this post helped a little bit to get started. I ended up like this :)

public function getImageFromDB($userId) {
		$storage_folder = 'emploees/';
		$the_file = $storage_folder . $userId.'.jpg';
		
		// check if we have an file
		if (Storage::disk('local')->has($the_file)) {
			// all we need is path, the rest will be done by Image lib
			$file_content = $the_file;
		} else {
			// no file - try to get it from db
			$db = DB::connection('somesqlconnection')->getPdo();
			$stmt = $db->prepare("SELECT Photo FROM UsersTable WHERE userId = ?");
			$stmt->execute([$userId]);
			$stmt->bindColumn('Photo', $lob, $db::PARAM_LOB);
			$stmt->fetch($db::FETCH_BOUND);

			if (strlen($lob) > 0) {
				Storage::disk('local')->put($the_file, $lob);

				$file_content = $lob;

			} else {
				Log::debug('No image for #'.  $userId );		

				// getting default image
				$file_content = $storage_folder.'unknown.jpg';
			}
		}

		// skips this if for some reason file content is empty
		if ($file_content) {
			// lets put Intervention/Image into work
			// this should result in resized and cached thumbnail 
			$img = Image::cache(function($image) use ($file_content) {
				$image->make($file_content)->resize(100, null, function ($constraint) {
					$constraint->aspectRatio();
				});
			}, 10, true);

			return Image::make($img)->response('jpg');
		}
		
	}

edit: actually Intervention/Image can make image even from some image path, so if we have an image on a filesystem and know exact place we can use it, there is no need to read the file and send the content