Questions are often along the lines of How should I properly run this in a Configuration Manager environment, or How often should I be running this maintenance. It’s not uncommon for conscientious Configuration Manager administrators to be unaware that WSUS maintenance should be run at all. Most of us just set up WSUS servers because it’s a prerequisite for a software update point (SUP). Once the SUP is set up, we close the WSUS console and pretend it doesn’t exist. Unfortunately, this can be problematic for Configuration Manager clients, and the overall performance of the WSUS/SUP server.
With the understanding that this maintenance needs to be done, you’re wondering what maintenance you need to do and how often you need to be doing it. The answer is that you should be performing monthly maintenance monthly. Maintenance is easy and doesn’t take long for WSUS servers that have been well maintained from the start. However, if it has been some time since WSUS maintenance was done, the cleanup may be more difficult or time consuming the first time. It will be much easier or faster in subsequent months.
Read the full article https://docs.microsoft.com/en-gb/troubleshoot/mem/configmgr/wsus-maintenance-guide