From https://reviews.llvm.org/D139645:

Given the following C:

extern int *data;
int f(unsigned idx) {
  return data[idx];
}

You would think we could emit

i32.load8_u	data($0)

But instead we currently emit

h:                                      # @h
	.functype	h (i32) -> (i32)
# %bb.0:                                # %entry
	i64.const	data
	local.get	0
	i64.extend_i32_u
	i64.add 
	i32.load8_s	0

We can't naively fold the add into the load offset though, because the effective address calculation is unsigned, which can overflow with negative offsets:

OK, so looking back at #29497 and D24053 this actually does look like the problem that we fixed back then.
IIRC the problem is that sometimes the address operand of the store (i.e. local 0, or L1 here) can have a negative value (here it's -128), but the store's effective address calculation (i.e. the operand plus the constant offset, L1 + args + 128 with this CL applied) is unsigned, so it will overflow.
So we have to ensure that the calculation that recombines the native local value with the compile-time constant (here 128) happens with an add instruction rather than getting folded.

For signed types, this is a problem. But there should be a way to do the folding for unsigned types.