The adaptive controller is designed to be custom-modded for different disabilities.
It’s actually a really cool system they designed in partnership with AbleGamers. They even have a mod for quadriplegic gamers. And it’s super affordable versus previous accessible interfaces.
Accessibility is one of the few places where Microsoft has been wholly good in recent years. Play any first-party Xbox game from the last few years, and you’ll see that the first menu that opens up first time you play is accessibility settings.