Well, for a start, your hard drive is underperforming:
Performance:
System Load: 1.16 (1 min ago) 1.06 (5 min ago) 1.05 (15 min ago)
Nominal I/O speed: 0.04 MB/s
File system: 18.39 seconds
Write speed: 78 MB/s
Read speed: 84 MB/s
We have a 2011 entry-level 21.5" iMac with the same drive specs (7200rpm on a 3GB/sec SATA bus) and our drive runs about 25 percent faster than yours in the same test. However, it also takes well over a minute to fully boot. I doubt with the pro Apps like the Adobe stuff you will see fast boots without a solid-state drive.
I would uninstall TechToo Pro or at minimum, set it to run on demand instead of running in the background. In the infancy of OSX, third-party tools like TechTools Pro, Onyx, Cocktail, and Disk Warrior were indispensable. Today the macOS is so highly evolved that those could now be interfering with elegant automated maintenance routines built into the system. I stopped using TTP and Onyx when I bought a Mac running os 10.6 Snow Leopard in 2008 and have found I do not need them any more.
That could contubiute to the sub-nominal drive speeds reported.
You may wish to test again with all the externals drives disconnected in case one of them is contributing to the issue.
From Diagnostics, the fact that so many Apple systems are behaving badly makes me suspect a interference with system function from one or more of the system modifiers the report flagged.
Do you have something stuck trying to install? Lots of RAM is getting use by a installer process:
Top Processes Snapshot by Memory:
Process (count) RAM usage (Source - Location)
installd 1.20 GB (Apple)
mds_stores 800 MB (Apple)
EtreCheckPro 720 MB (Etresoft, Inc.)
Finder 260 MB (Apple)
sandboxd 243 MB (Apple)