Normally no, you shouldn’t do anything to make sure cron works. In fact the plugin will warn you if it doesn’t.
The WordPress cron mechanism is not exact – it executes pending actions on the next page refresh. Some people choose to force WordPress cron to execute more regularly by triggering a curl request on the site, but this is rarely necessary. You can read about it here https://developer.wordpress.org/plugins/cron/hooking-into-the-system-task-scheduler/
Have you been able to determine if there are errors in the logs and if wp_mail works on your system?
If you don’t find anything in the logs you could insert some error_logs into the confirm_transactions() function to see if it runs, what it does, and if it fails at some point. Normally it is the one that should be changing your transaction status from unaccepted to pending.