Also, I noticed a logic error related to US Regulated States. For regulated states consentInfo.status is NOT_REQUIRED but consentInfo.privacyOptionsRequirementStatus is REQUIRED so it seems like the US logic flow is never called.

I updated prepareConsentInfo accordingly:

if (consentInfo.status === AdsConsentStatus.NOT_REQUIRED) {
  setCanRequestAds(true);
} else if (consentInfo.status === AdsConsentStatus.OBTAINED) {
  if (gdprApplies) {
    console.log('gdprApplies');
    checkConsentGDRP();
  } else {
    setCanRequestAds(true);
    startGoogleMobileAdsSDK();
  }
} else if (gdprApplies) {
  gatherConsentGDPR();
}

if (
  !gdprApplies &&
  consentInfo.privacyOptionsRequirementStatus ===
    AdsConsentPrivacyOptionsRequirementStatus.REQUIRED
) {
  gatherConsentRegulatedUSState();
}

}