I think @daedalus and I found out why people upgrading from Mastodon 4.5.18 to 4.6.x are finding a massive number of sidekiq jobs.
There's a bug in sidekiq version 4.0.9. Scheduled jobs (and retry jobs) in the past aren't queued. You can see this in the sidekiq web interface, a ton of jobs in Scheduled which are set to run in the past.
Upgrade manually to 4.0.10 and they all get queued.
Also upgrade Mastodon to 4.6.x, which has a later sidekiq, the same.
Ping. @darius I think we know what the reported queue backlog is from.