We've been running WSUS 2019 with 2019 servers for about a year now and for the most part they have been working without any problems. We currently have 30 2019 servers connected so it suggests that this is more of a problem with the server than with all the clients. As mentioned, this is not the first time that we have seen this problem which is also perplexing.
I've deleted a couple of servers from the WSUS console and run the commands to stop services and delete the four items from the registry. After the check for updates which is triggered by the last line, a couple of hours has been allow to pass. Both servers reappear in the WSUS console and the last contact date/time stamp is updated but neither client reports.
I've previously come across the article that you've linked to and been able to download the cab file and reach the client.aspx page from the servers. We do not use a GPO to push settings to the machines, instead settings are injected into the registry directly through our own scripts which also create an additional framework for our Windows Update process. This is partly done as we have machines in different domains all coming back to the one update server. The servers being tested at this stage are all in the same domain and IP subnet as the update server to ensure there are no additional factors which may be causing problems.
IPv6 is disabled on all our servers, HKLM\Software\Policies\Microsoft\Windows\WindowsUpdate\AU\UseWUServer is set to 1 and the results of the PowerShell command state that the Windows Server Update Service is the default (True) while Windows Update returns false.
The evidence does suggest that it is the WSUS server which is why we took the step to drop the database and reset all of WSUS so it was factory new again. To reduce the number of updates that would be available, only the Windows Defender definitions were synchronised with Microsoft Update and still the client servers won't report!!
Would welcome any other thoughts or suggestions.