@codebard Resolved. Following this user’s post in the plugin editor to the code resolved my issue entirely with sync not happening, though it’s not importing the right default image now. It still is showing those 401 unauthorized issues in health check but it seems to be allowing post sync anyway.
It looks like it’s having an issue if the file names are the same from the upload to Patreon. For example, I have 2 posts that use different “1.png” images. It looks like the post sync is using the same “1.png” for both, because the earlier post’s 1.png replaced the 1.png in the newer post’s body content.