Hi, @Justin Dietz
Thank you for posting in Microsoft Q&A forum.
Configuration Manager supports only the site database in an availability group, WSUS database is not supported by Configuration Manager in an availability group.
Here is the reference:
https://learn.microsoft.com/en-us/mem/configmgr/core/servers/deploy/configure/sql-server-alwayson-for-a-highly-available-site-database#configuration-manager-supports-only-the-site-database-in-an-availability-group
We can use a SQL Server Always On failover cluster instance to host the Configuration Manager site database. Failover cluster instances provide failover support for the entire instance of SQL Server and improve the reliability of the site database. However, it doesn't provide additional processing or load-balancing benefits. Failover cluster instances require the use of shared storage, which can be a single point of failure. Degradation in performance can occur, because the site server must find the active node of the failover cluster instance before it connects to the site database.
To use failover cluster instance for the site database, the site database server must be remote from the site server. The cluster can't include the site server.
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