After a recent update, I discovered I had both ZWave JS and ZWave JS UI running on top of the Z-wave built in. I rectified that and have the Z-Wave with only ZWave JS app running. Reconnecting half of my devices made me upgrade from my Zooz stick to the ZWA-2.
With that said, this issue seemed to be agnostic of which device was used.
When up and running, its fine, but when my VM restarts, unsure about just HA restarts (ill check next time) the Zwave integration shows not setup. I then reload the integration, and it “looks” like its working but it doesnt. I reload it again, and everything works great.
I suppose I could maybe write an automation on startup to wait, reload, wait reload, and that might work, but it doesnt solve the cause of the issue or explain what is happening.