Hi @DanaNolan ,
I actually ended up contacting Adobe about this issue, I'm pretty sure its due to their current version of Adobe Acrobat Pro through Adobe Creative Cloud, prior to CC I never had this issue on the older versions of Adobe and the issue does not occur in Foxit Reader so I do not think my issue was originating from anything ESRI related.
Also my raster imagery was filed based and I was still getting this issue.
My uneducated assumption is its some issue with the rendering of the layers in the latest Adobe Acrobat Pro. I noticed if I optimized the pdf by reducing file size/raster quality the layers would all draw in, the trade off being the image quality is less than ideal.
I did a video conference call with Adobe where they were able to reproduce the issue on their side too and they logged it as a bug, the last I heard from my contact person there was they were targeting a fix for May in the next update they release...I'm skeptically optimistic - the feedback I got from other users on their forum was that they were not the greatest at addressing similar user submitted bugs to them.🤔🙂