You're not missing anything, many other people have this issue. I had the same problem and was going mad (both insane and angry).
TL:DR (I have this from Adobe Illustrator Support, not the forums) this problem is due to Apple changing the way permissions work. It is NOT a Wacom driver issue.
Short term work-rounds:
1. (Worked for me for Photoshop as well as Illustrator) Go to your Brush Library -> Open Brush Library -> Wacom 6D brushes. Select one of those brushes, see if it is pressure-sensitive. I found those brushes to work when no Adobe native brush allowed me to select 'pressure' as a control. You can redefine that brush to be whatever brush (hardness/softness/size) you need.
2. Again, worked for me. Open a .eps or .ai file produced in an earlier version of Illustrator. Copy a pressure-sensitive brush stroke and paste it into your new Illustrator document. It brought its brush with it and that brush retained the pressure sensitivity.
From memory, once I'd done this on at least one occasion all the other brushes became pressure sensitive, even the ones that shouldn't be. But I could turn it off.
Sort-of explanation for the problem: The fact that some brushes worked perfectly while others did not told me that this was NOT a Wacom issue. The problem is that in the new OS the adobe software needs new/additional/different permissions to access the system controls/wacom data. If you look at System Preferences -> Security&Privacy -> Privacy, Wacom AND Adobe software must be showing in 'Accessibility' and in 'Automation' if Adobe software is to work as it should.
If you have to run the apps via terminal (?this is what the support person said, I don't know what it means but I know how to do it, described below) the brushes will work. Or so he said. If not, use the Wacom 6D brushes reconfigured until they work out how to solve this.
To run Illustrator via terminal:
Open your Applications folder, open the 'Adobe Illustrator 2022' folder.
Left-click or control-click on 'Adobe Illustrator 2022.app', select 'show package contents'
Open 'Contents', open 'MacOS'. You will see a file (icon is Unix Executable) named 'Adobe Illustrator'. Run it.
This opens a Terminal window, then Adobe Illustrator 2022 fires up. In theory the brushes will be useable in the app opened like this, but by the time I tried it I'd tried so many things that I can't remember if it worked or not.
Good luck!
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