Hey Adam,
I use Printful in my own store. Product Customizer, somewhat similar to Product Options, makes its own 'variants' that sometimes don't appear as "true" variants to carry over. From a quick look at your store, that doesn't seem to be happening to you.
It might be worth reinstalling Printful now that you have Options configured and trying to have the store sync again. If that doesn't work out, let me know. I'd love to check in. :)