Made an account specifically to share the solution. On Windows at least, there is an .exe file that deals with DirectX that, for some reason, goes missing.
Program Files (x86) > SquareEnix, Final Fantasy XIV - A Realm Reborn > game
Filename: ffxiv_dx11.exe
If you're missing this, you'll have to re-download the file. This would be why a fresh install of the game corrects the problem.
As for why the file went missing in the first place, I'm still trying to figure that out. Your antivirus software might be at play.
Details are in this Reddit post, including a link to the exe file.
https://www.reddit.com/r/ffxiv/comme...eb2x&context=3