As expected like Redis the clear cache is not working for the SQL server. To produce the bug configure the SQL server for caching and try to change the setting something like enabling and disabling the city and etc.
Nopcommerce should take distributed cache more seriously. Because without this feature, it is really difficult to run the shop at the distributed system.
enable sticky session is a killer for a distributed system.
The big problem is more cache has been added at 4.5, even at shopping carts and many other places have been cached. The SQL query has been cached and then the distributed cache is not working. Such a killing scenario for a distributed e-commerce. Nightmare.