The quote is marked as primary and associated with an opportunity.
You can manually synchronize quote line items with the associated opportunity using the Sync to Opportunity action available on the Quote detail page. This action appears in the Next Steps panel when the quote is set as primary and is associated with an opportunity, regardless of the quote's status, whether new, saved, finalized, or abandoned. When triggered, the line items from the quote are synced to the opportunity. If the quote is subsequently reconfigured and the shopping cart is modified, the updated line items are synced to the opportunity upon re-invoking the action.
Open the required quote and click Next Steps > Sync to Opportunity.