This is a bug I've been having the past few days that seemed to be an issue in previous versions of premiere. There's another post on it dating back 3.5 years ago that is marked as solved: Solved: Opacity Mask not Aligning - Adobe Community - 11442675
The issue seems to be practically the same but I followed the solutions listed on the previous bug report and was unable to fix it.
The problem has to do with keyframe masking. Making the initial mask seems to have zero problems, with the masked section lining up properly with the blue lines I've drawn. However, everytime I move keyframes and move the points of the mask, it becomes unaligned. The black masked out portion of the frame does not properly align with the blue line in which I've drawn, making it very hard for precision masking.
Version: 24.2.1
Platform/Version: Windows 11 Version 10.0.22631