Diablo 4 runs fine on my system, which has Windows 10 LTSC version 21H2. If you are still running version 1809 or older, I wouldn't be surprised there are problems running games since that build is over 5 years old at this point. If you have version 21H2, my first guess is your video driver probably need to be manually updated to a newer version. Windows LTSC doesn't like to auto update drivers as often as other versions of Windows.
I really like Windows 10 LTSC as a gaming platform but it does have some quirks, most of which have been covered in the
Windows 10 LTSC for gaming thread.