@TLarson3 the subscription confirmation link is the link that is behind the email confirmation button and takes you to the “Thank you for your confirmation” page; it is not the one that takes a recipient to the preference page.
There is no connection at all between the preference page and the double opt-in.
If the double opt-in is enabled, for US contacts that receive the double opt-in email, do not confirm (and are not exempt due to previously received emails etc - see the exceptions in the article), they will be dropped from marketing emails. In other words, a net new US contact must confirm the double opt-in to receive further emails. You would have to exclude forms or pages in the double opt in settings if you want to exempt contacts converting on certain pages from the process.