Do you have any other video cards passed through to this VM? Windows 10, AFAIK, does not have any way to globally assign which GPU should he designated as the primary. I tried previously to assign a Tesla M40 as the primary but could not, I had to move to Windows 11 which allows you to globally set which GPU you want to use if there are multiple.
As others have also said, you will more than likely need a dummy plug inserted in to one of the video out ports on the card, otherwise it may not function correctly (I have also had this issue in the past).
Finally, if you’re using RDP or VMware’s virtual console I don’t believe it will utilize the installed GPU correctly (I vaguely remember having this issue when I was setting up my cloud gaming rig, someone please correct me if I am wrong).