Can someone help me with my EtreCheck report?

I kind of agree with John Galt. I'd usually be a bit more conservative in my approach, but...

1. You have a fusion drive - which is often prone to failure, but the file system tests ran in 25.87 seconds (which is pretty good). The write speed is a bit low, but this fusion drive doesn't seem to be failing.
2. Surfshark AV is beasting your CPU for some reason. AV is generally useless but fairly harmless - not in this case. It is chewing up resources without any clear indications why. Which leads to:
3. There is a lot of old cruft on this system that is clearly from long-past installations - system mods and unsigned files (they have to predate SIP an Gatekeeper). Who knows what is in conflict on your system.
4. You have a lot - a lot - of audio plugins and tools. Guessing you are in that field - but again who knows what is conflicting amongst those.
5. The GeoBlocking/Verification tool is almost certainly doing low-level things that are causing issues - maybe it's what is spinning the AV around its axle.

Erase and reinstall might be the best bet here. Make sure you have a good backup or two first, of course. Be selective about what apps, plugins and other tools you reinstall afterwards.