Overview of the Issue
On the WPML setup page, when adding en_US (USA English) as a custom language, you will see an error saying “The Value en_US already exists.”
Adding an Existing Locale
By default, WordPress, and theme authors use the en_US locale for English. This is the reason you see the following error when trying to add a custom en_US locale: “The Value en_US already exists.”

Workaround
Instead of adding the en_US version, you can add any the English language (en locale) used in a different country other than the United States. Then, you can manually change the default flags to the respective ones.
How to Add a New Custom English Language:
Go to your WPML setup page under the Languages tab, and click on Create a Custom Language.
Choose English as the language, and select a location other than the United States (e.g., the United Kingdom). This way, the locale is set to en_GB (Language code and Country code), then click Save Language.

You now have two different versions of English:
- English: This one uses the en_US locale for The United States
- English (United Kingdom): This one uses the en_GB locale for The United Kingdom

After completing your WPML setup, you can customize the language flag, as both versions are using the UK flag.