I'm assuming you've already reviewed all of the troubleshooting steps on my guide below - a page made explicitly for this set of issues.
https://www.ajtek.ca/wsus/client-machines-not-reporting-to-wsus-properly/
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performing the proper WSUS maintenance including but not limited to running the Server Cleanup Wizard (SCW), declining superseded updates, running the SQL Indexing script, etc.?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/
To quote myself:
> Just because you’ve installed a new WSUS server, doesn’t mean that it’s clean or optimized; it just means that it’s NEW!
I looked on that page, and there are no optimization or maintenance that is mentioned in that guide.