There's streamdeck-ui (https://timothycrosley.github.io/streamdeck-ui/), which is an open-source alternative, but it at first glance it seems to be only for Linux.
There are a bunch of other macro/launcher pads like the StreamDeck that DO act as standard USB HID keyboards, though, and those should work fine with Keyboard Maestro using keyboard shortcut triggers.
Those other controllers are neat, but I want the pretty pictures, darn it!
But it does expose itself as a custom HID device! This project uses connects to all the StreamDeck models over WebHID. https://github.com/petele/StreamDeck-Meet
So I think the driver paranoid are actually in a decent spot.
If we say that Logitech app is 10 on a scale good to, well, Logitech, then Streamdeck’s software is ~3