Hi @Nate Cohen ,
Based on your issue description, I have below suggestions:
“The user does use iOS mail client to view email on her phone, but not during the times that the issue occurs. She is strictly using the desktop Windows click and clicking the accept button in there.”
I can understand that she was not using the device when the issue occurs but considering that duplicated meeting issues are commonly found out to be related to mobile devices, I’d suggest removing the email account from the device temporarily to see if the problem persists.
“I have wiped the user's local Windows profile clean and started fresh, and the issue appears again.”
Have you tried it with the calendar in OWA, what's the result?
Besides, if the user in question is involved in any manager-delegate relationship, it’s recommended that you remove delegates temporarily and check if there would be any difference.
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