Do you have Settings > Apps > App Store > (Automatic Downloads) App Downloads turned on?
I noticed apps appearing on my Home Screen I’d never heard of before. Turns out with that setting and Family Purchase sharing turned on, every time my wife installed a new app, it installed on my phone too.
That may not be your exact scenario, but I wonder if turning off that Automatic App Downloads setting (if enabled) changes anything. Could give you a clue, if so.
App Downloads and App Updates are both turned off. I don't have anyone else's devices on my account, just me. Thank you for the suggestions though!
Even with auto downloads turned off, does it show up in your app library or as a purchased app?
You can still have a app library with apps that "should be" downloaded, what happens if its removed from that list?