WTH is going on here?

As a workaround, you can manually refresh the air temperature value with the correct scale.

From HA, service:

service: zwave_js.invoke_cc_api
data:
  command_class: "49"
  method_name: get
  parameters:
    - 1  # sensorType: Air temperature
    - 1  # scale: F
target:
  entity_id: climate.z_wave_thermostat

From ZUI, click the refresh button in the control panel for Multilevel Sensor

The HA method will only refresh temperature. The ZUI method will refresh all sensors supported.