MIDI broke again this week despite having stopped Windows updates - and seemed like nothing got automatically updated without my OK.
Seems like its all due to the Windows 11 MIDI 2.0 updates - issues with are discussed here: https://devblogs.microsoft.com/windows-music-dev/windows-midi-services-rollout-known-issues-and-workarounds/
On that discord discussion a recent update allows for rolling back the MIDI 2.0 to legacy while still keeping Windows up to date: https://microsoft.github.io/MIDI/kb/how-to-change-api-mode/
I've updated Windows and set the MIDI API Mode to Legacy, and all is well.
Somewhere on the Discord was mentioned that a big drop is expected in November which may address the bug with the Helix and other devices that aren't 'Class Compliant'.