Can you hear any MIDI sounds from the on-board synth? If not, perhaps the MIDI playback is disabled or the faders are way low. Otherwise, maybe you are sending the MIDI signal for the metronome to a different port that is not connected to a sound source.
In that Metronome toolbar, click on the Metronome settings button (typically the last one in the toolbar; looks like a Metronome with three little lines at its lower left corner). This opens the Project Options dialog box with the Metromone tab selected. There's a section labeled MIDI Note. What's the Port set to, and the Channel? (Also check the Velocity values for the First Beat and Other Beats at the bottom of this dialog box -- if they were set to 0 or really small values the ticks would be inaudible. And the Key values -- if you are using Channel 10 on the Sound Blaster as a sound source, and the selected note is not part of the drum kit, again you might have an inaudible tick.)
Next go to the MIDI Ports dialog box (Options menu -> MIDI Devices...). What's selected on the left? In my case just the SB AudioPCI 64V MIDI Synth was selected. This is Port #1 in the Project Options/Metronome dialog box. If I also select the SB AudioPCI 64V MIDI Out, this will now be Port #2, and could be selected for the metronome output.
I hope this helps. Check all the possibilities -- which MIDI port the metronome is using, which channel, which note values and which velocities are being used to be the "tick," and that these settings tie into a port and channel that you can hear sounds from...
-AlChuck