We study the effects of inertia in dense suspensions of polar swimmers. The hydrodynamic velocity field and the polar order parameter field describe the dynamics of the suspension. We show that a dimensionless parameter R (ratio of the swimmer self-advection speed to the active stress invasion speed [Phys. Rev. X 11, 031063 (2021)2160-330810.1103/PhysRevX.11.031063]) controls the stability of an ordered swimmer suspension. For R smaller than a threshold R_{1}, perturbations grow at a rate proportional to their wave number q. Beyond R_{1} we show that the growth rate is O(q^{2}) until a second threshold R=R_{2} is reached. The suspension is stable for R>R_{2}. We perform direct numerical simulations to characterize the steady-state properties and observe defect turbulence for R<R_{2}. An investigation of the spatial organization of defects unravels a hidden transition: for small R≈0 defects are uniformly distributed and cluster as R→R_{1}. Beyond R_{1}, clustering saturates and defects are arranged in nearly stringlike structures.