Welcome William Barrett,
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Thank you for providing such a detailed description of the issue.
Before I assume there is a problem with the icon sorting logic itself, I'd like to narrow down a couple of details:
Are all 69 items located directly on the Desktop, or are some of them shortcuts that come from the "Public Desktop" folder?
- Press "Windows + R", type: shell:desktop> then press Enter.
- Check whether all affected icons appear in that folder.
- When you right-click an empty area of the Desktop and select "View", is "Auto arrange icons" enabled or disabled?
- Does the same behavior occur if you temporarily switch to "Large icons" and then back to "Medium icons"?
As a quick test, please also try refreshing the Desktop icon layout:
- Right-click an empty area of the Desktop.
- Select Sort by > Name
- Press F5 to refresh the Desktop.
- Sign out of Windows and sign back in.
Looking forward to your update.