Yes, only empty the Download folder. Anything further would be risky and unnecessary. My whole Software Distribution folder is only 116 MB after 6 years.
I have many times stopped wuauserv and bits, then rd /s %windir%\SoftwareDistribution and then you start wuauserv and bits, and wuauclt /detectnow
You then will have to select Microsoft Update from the windows update website if you want the updates for office and other tools to be detected.
This process is given in at least one of many KB articles on troubleshooting WU.



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