Hi @Exchange_Newbie ,
Microsoft recommendation is to install the latest cumulative updates. However, it also depends on the organization and can go either latest or 1 less than the latest CU i.e. N or N-1
For AD changes, yes. You need to run the below before upgrading,
setup.exe /prepareschema /IAcceptExchangeServerLicenseTerms
setup.exe /prepareAD/IAcceptExchangeServerLicenseTerms
https://learn.microsoft.com/en-us/exchange/plan-and-deploy/install-cumulative-updates?view=exchserver-2019
https://learn.microsoft.com/en-us/exchange/plan-and-deploy/prepare-ad-and-domains?view=exchserver-2019#exchange-active-directory-versions
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