I spoke too soon. I was able to get it working once, but since then it still hangs when creating the Xaudio device. Sometimes it does work after 30+ seconds, but most of the time it just hangs on the black screen still, regardless of which audio device I'm using.
Log section from when it worked:
05/05/2021 00:59:42 | Created clock.
05/05/2021 00:59:42 | Created graphics manager.
05/05/2021 01:00:17 | Created XAudio2 device.
05/05/2021 01:00:17 | Created audio manager.
When it doesn't work it still just hangs at a black screen for minutes just after "Created graphics manager".
Deleting settings file doesnt seem to change behavior, and I'm using a vanilla install without any mods of the most recent version now. I got it working once, then it started showing the black screen behavior again, then inexplicably it worked again once, and now it hangs on every startup without configuration changes. It's really frustrating to have it work sometimes but not other times with seemingly no changes.