Sure does. There is a way to execute 64-bit PowerShell. To do that, checkout https://support.automox.com/help/enforce-windows-registry-settings-worklet just under the “64-Bit Registry Workaround” section or see the 64-bit example below.

Before that, the net commands still work for x86 powershell

net user ITAdmin $password /ADD /Y

net localgroup Administrators ITAdmin /ADD

Here is a 64-bit example

$scriptblock = {

    ############# EDIT HERE ############
    $account = "ITAdmin"
    $description = "IT local admin account"
    ####################################

    # Function to generate Random Passwords
    function New-RandomPassword {
        param(
             Parameter()]
             int]$MinimumPasswordLength = 18,
             Parameter()]
             int]$MaximumPasswordLength = 29,
             Parameter()]
             int]$NumberOfAlphaNumericCharacters = 9,
             Parameter()]
             switch]$ConvertToSecureString
        )
        Add-Type -AssemblyName 'System.Web'
        $length = Get-Random -Minimum $MinimumPasswordLength -Maximum $MaximumPasswordLength
        $password = sSystem.Web.Security.Membership]::GeneratePassword($length,$NumberOfAlphaNumericCharacters)
        if ($ConvertToSecureString.IsPresent) {
            ConvertTo-SecureString -String $password -AsPlainText -Force
        } else {
            $password
        }
    }

    # Generate random password
    $pw = ConvertTo-SecureString "$(New-RandomPassword)" -AsPlainText -Force

    # Create User Account and Add to Administrator Group
    New-LocalUser $account -Password $pw -FullName $account -Description $description -verbose
    Add-LocalGroupMember -Group Administrators -Member $account -verbose

    # Validate Account was created
    $ac = Get-LocalUser $account
    IF($ac){
        $grp = Get-LocalGroupMember Administrators
        IF($grp){
            # Account exists and is a local admin
            return 0
        }else{
            # Account exists but is not a local admin
            return 2
        }
    }else{
        # Account doesn't exist return 1
        return 1
    }
}

# Run scriptblock in 64-bit powershell
$64bit = & "$env:SystemRoot\sysnative\WindowsPowerShell\v1.0\powershell.exe" -ExecutionPolicy Bypass -WindowStyle Hidden -NoProfile -NonInteractive -Command $scriptblock

$out = switch ($64bit)
{
    0 {"Succesfully created $account and added to local admin group"}
    1 {"Failed to create $account"}
    2 {"Succesfully created $account and failed to add to local admin group"}
    Default {"$64bit"}
}

Write-Output $out
Exit $64bit

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Thank you so much! This is perfect. 

Wouldn’t the following line require more specificity if it’s to validate that the account is within the admin group? It looks like it only checks if there are any administrators at all.

$grp = Get-LocalGroupMember Administrators

Does this change improve the effectiveness?

$grp = Get-LocalGroupMember Administrators | Where-Object {$_.name -like "*$Account*"}