Real-time scan for new files no longer working

This sounds to me like your library has just grown to a size where it reached the current limits defined on your OS. Try to check the limits and compare them to the total count of files and folders in your Roon watched folder. Does it match? Please read:

Note: Realtime watching is done by the OS (Kernel and drivers). A userland process like Roon just asks to be notified when a change happens. If the OS doesn’t send notifications for changes, for example because watch limits are reached, the process can obviously not react.

Update:

Add folder count and probably there are also some other files like pictures and PDFs … this might very well add up to the often used 8192 default limit.