I have partially solved my issue.
Maybe it will solve yours?
There are a bunch of optimizations that can be done, and I am still doing testing to get it completely optimized, but for me, the main cause was strange;
After a BIOS reset, the issue above is gone.
I have been stewing in my own funk in this lonely thread: https://answers.microsoft.com/en-us/windows/forum/all/sudden-choppylaggy-audio-in-windows-11/17fb92ef-fa1b-4b90-b557-a57d07e42440
Be very certain that you actually reset the BIOS, my Z790 motherboard seems to have a faulty "BIOS RESET" button, that doesn't actually do it. Pull the CMOS battery for at least 10 secs with no power connected.
Maybe it will help you.