Starting 02/12/2024 you're required to submit medical I-683) with I-485.
If you don't include it, your petition will be rejected.
P.S. Not everybody needs to submit I-693. If you did DS-3025 as part of K-1 process, it's still valid and all vaccinations were taken which is reflected on the form, you don't need to do I-693.
Personally, for K-1 filers, I'd include copy of DS-3025 with I-485 to avoid rejection just in case.
Source: https://www.uscis.gov/newsroom/alerts/uscis-now-requires-report-of-immigration-medical-examination-and-vaccination-record-to-be-submitted