The .summaryElement accessibility trait causes VoiceOver to announce that element when the app starts. The element won't get the focus though, and the order is not affected. A candidate for this trait could be the rings info in the Activity app.

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The Accessibility APIs are generic and flexible. They're not just for VoiceOver. If you implement them right, you can do it once and it will very likely work great for VoiceOver, Voice Control, Switch Control, Full Keyboard Access, and more. That's why, to start with, we tend to focus on VoiceOver, the same way you may focus on keyboard navigation for the web. A great VoiceOver experience will get you most of the way to a good experience with the other assistive technologies. We've seen one example with Custom Actions. One implementation works for: VoiceOver: https://x.com/dadederk/status/1550099327053451266 Switch Control: https://x.com/dadederk/status/1551236244088279040 Full Keyboard Access: https://x.com/dadederk/status/1551874732504629249 And Voice Control: https://x.com/dadederk/status/1552253520182640645 Of course that doesn't mean you don't have to test and check how the experience is with the other technologies. But before feeling overwhelmed, or for small teams, making sure your app works for VoiceOver is a great start.
An alternative layout for large font sizes can be provided with Auto Layout by having three sets of constraints (common, default constraints, and alternative constraints) and activate/deactivate them depending on the content size category.

When implementing a UISlider, it is a good idea to consider how much the slider value should change when swiping up/down to adjust it. It might not always make sense to do it in 10% increments, which is the default behaviour. Could be because the value at those intervals doesn't make sense, or feel random, or because it wouldn't provide the user with a fine enough control being able to go through the whole slider in just 10 swipes. It user will still be able to adjust the slider to any value by double tapping and holding and then moving the finger left or right, bypassing VoiceOver gestures. VoiceOver announces the new value as it changes.