FWIW I had some success (I can now install my app to Apple Watch Ultra, but I of course cannot debug) by doing
Close XCode
Go to /Users/username_here/Library/Developer/Xcode/watchOS DeviceSupport
Duplicate the folder "Watch6,9 8.7 (19U66)"
Rename the duplicate to "Watch6,18 9.0.1 (20R8380)"
Start XCode again
Now I can at least do some limited testing on the Apple Watch Ultra. This is with XCode 14.0, WatchOS 9.0.1, on MacOS 12.5.1, no additional Beta profiles
axryp
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Same here - XCode 14.0 and WatchOS 9.0.1. No beta profiles, just plain vanilla released developer tools and released OS. Extremely annoying. Is there any other way to transfer the required debug symbols for 20R8380 from another developer/XCode install?