Custom actions work with VoiceOver, Switch Control and Full Keyboard Access. They also do for Voice Control. You can say "Show actions for <item name/number>", and an action sheet with all options, numbered, will be presented to the user.

For some use-cases, Voice Control users might not feel it is a big win. Navigation is not as big of an issue, and interacting with custom actions might be a bit trickier than with "exposed" buttons. But lots of times seems a fair compromise.

