For a couple months the launcher would start, get a progress circle, and hang. Game worked fine if I launched from the DX11 EXE. Finally figured it out:

My card does not support Vulkan (Dell E6430 OEM issue not NVidia) and even though I have DX11 selected, Larian Launcher was choking because there was a Vulkan driver in SYSTEM32. As soon as I deleted the Vulkan DLLs the issue goes away.