I find that sealant works 60% of the time if the puncture is big enough to be seen. If the puncture is big enough to be seen wit the naked eye or doesn’t want to seal, I pull the tire off and use a patch on the inside.
I run my tires up to 120 PSI on the rollers (70-80 on the road), and haven’t blown out a repair in 2 seasons of running tubeless on the road. I did switch to orange sealant, but I’m not 100% sure it makes that much difference.