Hello @Dennis Schults
Please run below NPS Extension Troubleshooter Script using PowerShell under Admin Privileges to identify the issue. You can use this script to see if all the required endpoints are reachable, valid certificate is present or not, if any required updates are missing and so on. If no problem is detected and you are still facing the issue, this script also includes an option to collect required logs which you can provide to MS support in the support ticket as well.
You can download the script from TechNet: https://gallery.technet.microsoft.com/Azure-MFA-NPS-Extension-648de6bb
Please refer to the screenshot below to see all the checks this script performs:
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Please "Accept the answer" if the information helped you. This will help us and others in the community as well.