The German Healthcare System is moving to the TelematikInfrastruktur 2.0, which has foundations in Zero Trust security, which includes also remote attestation and proof with TPM.

I had made a dummy client as example and I must say that on development perspectives, it is wild.

There are some Go libraries, which support only RSA instead of EC for TPM Keys, on the C++ side you get most of results in Windows through the CryptoProvider, on Linux and Mac exists own OS solutions/access.

Implementing it isn't trivial at all, otherwise you would already seen (not vibe-coded) open source implementions spawning on GitHub.