The serverless docs are not accurate in the refresh index docs.
In short, it states that
By default, Elasticsearch periodically refreshes indices every second, but only on indices that have received one search request or more in the last 30 seconds.
which is currently not true in serverless, where the refresh is happing every 5 seconds. In addition the refresh can not be set to a value lower than 5 seconds, which is also something worth noting (although this might change in the future).