The potential importance of short-distance nuclear effects in double-β decay is assessed using a lattice QCD calculation of the nn → pp transition and effective field theory methods. At the unphysical quark masses used in the numerical computation, these effects, encoded in the isotensor axial polarizability, are found to be of similar magnitude to the nuclear modification of the single axial current, which phenomenologically is the quenching of the axial charge used in nuclear many-body calculations. This finding suggests that nuclear models for neutrinoful and neutrinoless double-β decays should incorporate this previously neglected contribution if they are to provide reliable guidance for next-generation neutrinoless double-β decay searches. The prospects of constraining the isotensor axial polarizabilities of nuclei using lattice QCD input into nuclear many-body calculations are discussed. DOI: 10.1103/PhysRevLett.119.062003 Double-β (ββ) decays of nuclei are of significant phenomenological interest; they probe fundamental symmetries of nature and admit both tests of the standard model (SM) and investigations of physics beyond it [1]. Consequently, these decays are the subject of intense experimental study, and next-generation ββ-decay experiments are currently being planned [2][3][4]. At present, both the robust prediction of the efficacy of different detector materials, necessary for optimal design sensitivity, and the robust interpretation of the highly sought-after neutrinoless ββ-decay (0νββ) mode are impeded by the lack of knowledge of second-order weak-interaction nuclear matrix elements. These quantities bear uncertainties from nuclear modeling that are both significant and difficult to quantify [5]. Controlling the nuclear uncertainties in ββ-decay matrix elements by connecting the nuclear many-body methods to the underlying parameters of the SM is a critical task for nuclear theory.In this Letter, lattice QCD and pionless effective field theory [EFTðπ Þ)] are used to investigate the strong-interaction uncertainties in the second-order weak transition of the two-nucleon system in the SM by determining the threshold transition matrix element for nn → pp. This matrix element receives long-distance contributions from the deuteron intermediate state whose size is governed by the squared magnitude of the hppjJ þ μ jdi matrix element of the axial current that has been recently calculated using lattice quantum chromodynamics (LQCD) [6]. In that work, the two-body contribution to the matrix element (i.e., that beyond the coupling of the axial current to a single nucleon) was constrained, quantifying the effective modification (quenching) of the axial charge of the nucleon from two-body effects. Here, it is highlighted that the nn → pp matrix element receives additional short-distance contributions beyond those in jhppjJ þ μ jdij 2 arising from the two axial currents being separated by r < Λ −1 ∼ m −1 π [where Λ is the cutoff scale of EFTðπ Þ], referred to herein as the isotensor axial polarizability. Usi...