Just had this happen. Was in mage quarter, popped 2nd orb right before pulling last portal master and the charge was used, but no sanity restore and the run ended.
I dont think it charges up while in combat anymore, I have noticed if I pop before pull I dont get any back, until combat is over so dont pop during a pull. Not sure if bug or as intended unlike last time you could pull and have it going.
It restores at half the rate while in combat currently.
You also still need to stay near it to get its effect at all. As mentioned above, it still charges you over time at either 10% of your original max sanity per second (ignoring Long Night’s halving), or 5% if in combat. With one rank in Expansive Mind from the first reset, this resulted in 105 or combat alternating ticks of 52/53.