Local SEO is not just Google Business Profile. It's the combination of your GBP signals, your website's local relevance signals, your citation consistency across the web, your review count and velocity, and the geo-targeted content on your site. All of these factors contribute to where you appear in local search results.
The single highest-leverage fix most local businesses haven't made is their GBP primary category. We've seen businesses with 140 five-star reviews not appear in the map pack for their primary service — because their GBP primary category was a generic 'Healthcare provider' instead of 'Urgent care center'. That single change, which takes five minutes, can move a business from page 2 to position 1 in the local pack.