This is the AMD's reply to my ticket:
Thank you for your response
Thank you for providing the details ,
I request you to give a try by performing clean installation of latest driver 20.1.4 or the available driver to your OS by using the AMD Cleanup utility.
I suggest you to please disable the windows auto update in the "Show and hide" tool
To be on the safer side, I request you to please create System Restore point before performing any troubleshooting steps.
Step 1 – Please use AMD Cleanup utility. It will help you completely uninstall AMD graphics card drivers and packages from your system, without leaving leftovers behind.
Step 2 – Then use the latest drives
and select "factory reset".
Thanks for contacting AMD.
For me, the solution was the optical toslink cable with my sound blaster Z. it sounds amazing and no problems with audio delay.
I wish AMD paid for my old sound blaster which was the savior of the day.
That's basically the same reply I received from AMD, they told me to use DDU and do clean windows boot. Except, this is a brand new system and a fresh install of windows with nothing on it but basic drivers and a few games. I'm trying to push them to allow me to speak with someone at AMD as they are likely just 3rd party tech support. I'm not sure why they are so determined to keep their head in the sand about this issue.
I'm probably going to do the optical cable as well but I really don't want to since it's such a dated and limited connection that hasn't been updated in decades. Plus I'd have to use the onboard audio, I do have a SB Zx but it would cover up one of the fans on the graphics card so I don't really want to use it.