Judging from the number of responses, IACV seems to be the number one reliability issue for these Lexus/Toyota V6s. Our ES300 had it too. Not wanting to tear up too many seal gaskets or screws, I tried the short-cut method of spraying the pintle area and idle air passage with carb cleaner then WD40 after removing the black solenoid cover. It did not give me a good feeling because the design causes drippings to collect at the bottom of the throttle body where the IACV is mounted. It worked for a few months but now the problem is returning.
Does anybody know if a puff of grayish-blue smoke during cold starts has anything to do with this IACV issue? I've heard it might be PCV valve.
Back to IACV clean-up, it looks like I will attempt a full disassembly and cleaning. The design seems sub-optimal since all crud and debris tends to accumulate in the IACV, but that's just how it is on these Toyotas. I will try to pre-order the seals (thanks for the list of 3 seals, phobang). Smoother transmission shifts might make sense if the IACV is used by the drivetrain ECU to momentarily reduce power during shifts.
Excellent contributions, everybody.