Small Fermi energy effects are induced in MgB2 by the low hole doping in the σ bands which are characterized by a Fermi energy E σ F ∼ 0.5 eV. We show that, due to the particularly strong deformation potential relative to the E2g phonon mode, lattice fluctuations are reflected in strong fluctuations in the electronic band structure. Quantum fluctuations associated to the zero-point lattice motion are responsible for an uncertainty of the Fermi energy of the order of the Fermi energy itself, leading to the breakdown of the adiabatic principle underlying the Born-Oppenheimer approximation in MgB2 even if ω ph /EF ∼ 0.1−0.2, where ω ph are the characteristic phonon frequencies. This amounts to a new nonadiabatic regime, which could be relevant to other unconventional superconductors.PACS numbers: 74.70.Ad, 63.20.Kr, Four years after the discovery of superconductivity at 39 K in MgB 2 , 1 the superconducting properties of this material are still object of investigation. One of the anomalous characteristics of MgB 2 with respect to conventional ME superconductors is the remarkable smallness of the Fermi energy E σ F associated with the holelike σ bands, which are the most involved in the Cooper pairing. ME theory holds true indeed only if the Fermi energy E F is much larger than any other energy scale of the system. Several analyses indicate however that this is not the case of MgB 2 . LDA calculations, for instance, estimate the energy distance between the chemical potential and the top of the σ bands to be ∼ 0.4-0.6 eV, 2,3 in agreement with ARPES measurements. 4 Estimates of the Fermi energy can be inferred also from penetration depth measurements giving E F = 3200 K in MgB 2 , 5 and even less in Al and C doped compounds. 5,6 In previous studies we have analyzed some of the effects related to a small Fermi energy E σ F on different electronic and vibrational properties of MgB 2 . One of these effects is the breakdown of Migdal's theorem, and consequently of the Migdal-Eliashberg diagrammatic theory, which occurs when the Fermi energy E σ F and the phonon energy ω ph are comparable (ω ph /E σ F < ∼ 1). 7,8 Another one is the remarkable anharmonicity of the E 2g phonon mode, related to the splitting in energy of the σ bands under the E 2g distortion. 9 In this paper we want to discuss in greater detail new physical consequences of the comparable size of E σ F and the E 2g splitting energy of the σ bands in MgB 2 . In particular we review in a critical way the validity of the adiabatic Born-Oppenheimer (BO) approximation for the E 2g phonon, which is the most relevant to the superconducting pairing. As our main result we show that, due to the large quantum fluctuations associated with the zero point motion, the BO principle is broken down independently of the ω ph /E σ F ratio. This novel kind of adiabatic breakdown is thus shown to be related to the parameter κ = g E2g /E σ F , where g E2g is the electron-phonon matrix element which couples the electrons in σ bands to the E 2g phonon mode in MgB 2 . A simple quantum ...