Create a Role in the Xbox App - Xbox Controller

With the software you can at least verify if the adaptive controller is functioning correctly which will give you a better start point for troubleshooting.

you may want to check this link:

Customize adaptive controller

Customize the Xbox Adaptive Controller in the Xbox Accessories app

• The Xbox Accessories app is available on Xbox One and Windows 10.
• The Xbox Accessories app won’t detect your controller if you’re using Bluetooth to connect to your PC. Connect your controller using Xbox Wireless, or plug the included USB-C cable into the back of the Xbox Adaptive Controller and plug the other end into
  your PC. For more info, see
  Connect the Xbox Adaptive Controller to a PC.
• If the Xbox Accessories app isn’t installed on your PC, you can get it in the Microsoft Store.

Create profiles and switch between them

To create a controller profile:

1. Using your Xbox Adaptive Controller, open the Xbox Accessories app.
2. Scroll to the Xbox Adaptive Controller, then select Configure.
3. Select New profile, give your profile a name, then configure your changes.
   
   Note Any button that you reassign will also apply to other inputs that have the same value. For example, if you reassign
   D-pad down on the face of the controller to the
   Y button , then the
   D-pad down 3.5mm port will also be assigned to the
   Y button .
4. When you’re done, press the B button.

Create multiple profiles in the app and switch between them using the Xbox Adaptive Controller’s built-in
Profile button.

1. Open the Xbox Accessories app, scroll to the Xbox Adaptive Controller, then select
   Configure.
2. In Profiles, select a controller profile you’ve created or create a new one.
3. Choose a slot.

You can assign a slot for up to three profiles. Press the Profile button on the Xbox Adaptive Controller to switch between them. When no bars appear lit next to the
Profile button, the controller is using the default button mapping.

With the Xbox Adaptive Controller you can customize your experience. Use the Xbox Accessories app on Xbox One or Windows 10 to further customize your experience through button remapping and profiles. Create multiple controller profiles in the app and instantly
switch between three of them with the built-in Profile button.

Hi there Volcannon,

Thanks for reaching out. I'm sorry to hear about the issue with creating slots/profiles for the accessory device. What accessory are you working with? (Xbox One wireless controller, Xbox One Elite wireless controller, Adaptive Controller)

I recommend taking a look at the following troubleshooting articles:

• How to customize an Xbox One Wireless Controller with the Xbox Accessories app
• Use the Xbox Accessories app to configure your Xbox Elite Wireless Controller

Try this out and let us know the results.

Hello BeauThompson,

Thanks for reaching out to the forums. You can download the Xbox accessories app on your Xbox console or PC so you can create a profile and customize your Xbox Adaptive controller. This video should help guide you to create a profile and start customizing.

https://youtu.be/dlHmJdHQRG0

You can get more support with these articles:

Customize the Xbox Adaptive Controller in the Xbox Accessories app | Xbox Support

Xbox Adaptive Controller FAQ | Xbox Support

Play with the Xbox Adaptive Controller | Xbox Support

This is a widespread issue for everyone using the Xbox Accessories App. You can update the Elite controller if you have a physical Xbox console, but the current Xbox Accessories App does not have an option to update an Elite controller. Other Xbox hardware, such as non-elite Xbox controllers or the Xbox Wireless headset do have update UI that works, but the Elite does not show that as an option, possibly because the UI button was replaced with "Rename".

Refreshing, reinstalling, updating the App or Windows will not fix this issue. Microsoft needs to update the Xbox Accessories App with a fix. That's the only way to solve this issue that Microsoft created.