However, the intersection of typescript, nodejs, and ES modules is consistently the most frustrating experience I ever have. Trying to figure out which magic incantation of tsconfig/esbuild/tsc/node options will let me just write code and run it is a fools errand. You might figure something out, and then you try to use Jest and then you descend into madness again.
The biggest tip I can give people is to ditch ts-node and just use (the awkwardly named) tsx https://github.com/privatenumber/tsx, which pretty much just "mostly works" for running Typescript during dev for node.
The problem mostly seems to stem for all the stakeholders being pretty dogmatic to whatever their goals are, rather than the pragmatic option of just meeting people where they are. I really wish the Node, Typescript, Deno/Bun, and maybe some bundler people would come together and figure out how to make this easier for people.