You have disabled Apple Security by disabling security Updates, and instead activated several third-party items. That is a mistake:
By far the easiest way to ruin performance and cause instability is to install ANY third-party speeder-uppers, Cleaners, Optimizers, Virus scanners or a VPN that you installed yourself. Third-party File Sync-ers such DropBox, BackBlaze, OneDrive, or GoogleDrive can ruin performance but are not inherently dangerous
The idea that a third party, with no special knowledge of the inner workings of MacOS, can somehow find a simple way to protect your computer that is not already being done by MacOS itself suggests that the MacOS developers are somehow "holding out on you". That is absurd.
You should remove any and all other virus scanners, speeder uppers, optimizers, cleaners, App deleters or VPN packages you installed yourself, or anything of that ilk.
You have remnants of THREE VPN and a Proxy server showing in your report. The correct number is ZERO, unless you are using one provided by your Institution, in which case they provide support for it as well.
You have enabled MalwareBytes scan-always. We love MalwareBytes for its ability to scan for viruses ONCE, but have no love for its enormous time wasting of scanning at all times. Turn that OFF.
You have VirtualBox loaded at version 6.1.18. the current version 6 is 6.1.48, and will be discontinued at the end of this calendar year in favor of version 7, currently at version 7.0.6.
some portion of your version of iMazing is unsigned. Any legitimate software that does what it claims to do in this environment should be signed by the certificate of a legitimate developer. Some portion of your version of Anytrans is not signed.
Some portion of your version of Megaupdater is not signed. Anything that does what this package claims to be doing should be signed.
You should use the list of "clean Up" items to hunt down and remove each and every one of the files listed, or pay to upgrade etrecheck and it will remove each one with one click each.