The currently available HA options for PMP are *odd* to say the least. In our environment we had to use Veeam replication with a local MSSQL installation to workaround the issues noted below.

Bidirectional SQL replication

-Does not scale past 2 SQL nodes.

-No way to resolve some write/delete conflicts

-https://techcommunity.microsoft.com/t5/azure-database-support-blog/considerations-on-bidirectional-transactional-replication/ba-p/3603117

PMP HA

-Main limitation is primary/secondary nodes need to have the same IP. This is often impossible in a multisite configuration (where each site has a separate subnet).

The best way to go about preventing SQL conflicts and not needing the same IP would be to support SQL availability groups. This is super common in any environment with multiple SQL nodes and comes standard in any application that has an SQL backend.