I'm quoting from a Windows environment so it may not be exactly the same but I think the following premise extends to Macs as well.
LR Print Templates will not only store the LR print settings, but the Printer driver settings in the OS as well. The Profiles you select in the Print Job section of LR have no driver settings so it may seem random when choosing a profile and then trying to make an association to driver settings.
The process that works for me is to first use the Page Setup button to make all of the driver settings, page size, turn off color mgmt...
Then make all of the LR settings I need and create a Print Template.
This stores the driver and LR settings in the Template.
If you apply a Template and find you need to make driver tweaks. If you want to save the tweaks, be sure to right click (Mac Opt Click?) and Update the Template. Otherwise the Template will have the old setting.