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This is a known IAM propagation quirk, not a proxy bug: re-grant the role to force it to take effect. Remove the Cloud SQL Client role from the failing service account in IAM & Admin > IAM (uncheck it and Save), verify the account disappears from the list, then Add it back with the Cloud SQL Client role and Save. Multiple users confirmed this fixed the identical 403 createEphemeral error, with one reporting the fix was still relevant two years later. Also double-check the connection name for typos — project IDs use dashes, not underscores, which was the original reporter's first mistake. Source: https://github.com/GoogleCloudPlatform/cloud-sql-proxy/issues/37
Source: https://github.com/GoogleCloudPlatform/cloud-sql-proxy/issues/37