Thank you for your help. Your exact example didn't work, I had to modify it a bit but now I have working code.

#include "freertos/FreeRTOS.h"
#include "freertos/task.h"
#include "tinyusb.h"
#include "class/hid/hid_device.h"
#include "esp_log.h"
#define TAG "KVM_Trigger"

enum
{
ITF_NUM_KEYBOARD ...

I have a KVM Switch that has a hotkey to switch between devices. The hotkey works when we press Ctrl then Ctrl and then 1 (or 2,3,4) on a keyboard.

I am not that experienced with ESP IDF but I was able to modify the examples in the repo to something that can press they keys like I want.

Here's ...