First, if you are creating a custom elevation tag here is the process from the help documentation.
One of the most important items to keep in mind when creating a custom elevation tag is the nested family pointer orientation. Make sure each nested pointer family is created in the same orientation; up.
For example, this custom elevation family has 1 body [host] and 3 pointer families [nested]. Each pointer is different and the orientation for each is based on their insertion side:
Using this as an example, there are 2 primary issues you will notice if there are multiple nested pointer families and the orientation is not facing up for each:
1. Placement: Direction Detection \ Body Family Rotation
During placement, the elevation view may not properly detect the face it should be aligning with. Also during this process, the body elements and labels may rotate with the tag:
2. Additional View Checkbox Locations
Selecting the elevation tag will not display the Show Arrow view checkboxes in the expected locations due to the orientation of the nested pointer families:
I have included the images below for the correct orientation, and the results: