WSUS requires a bunch of optimisations and ongoing maintenance. Are you performing the proper WSUS maintenance including but not limited to running the Server Cleanup Wizard (SCW), declining superseded updates, running the SQL Indexing script, etc.?
https://www.ajtek.ca/wsus/how-to-setup-manage-and-maintain-wsus-part-8-wsus-server-maintenance/
WAM (full disclosure: our product), runs through every single check to make sure your entire WSUS infrastructure is clean, and optimised with all of the appropriate changes in IIS and the SQL Database and if there are any recommendations, it provides very easy ways to adjust them through a command on the WAM Shell like:
Set-ApplicationPoolMemory -Name "WsusPool" -NewMemoryValue 4096
Set-WsusIISLimitInterval -Minutes 15
These are just 2 examples of over 14 different optimisations that need to happen to WSUS to keep it in top shape.