The DEM to 3D plugin in QGIS works well, and I found that by using raster tools and functions you can create some good cartography products. I posted this article on my personal blog on how it can work. https://justincolegis.com/2022/04/13/creating-a-3d-printed-trail-map-for-people-who-are-visually-impaired/. When I did that post, I was doing a lot using geoprocessing, but found that the raster functions and doing more in the layouts can give a better product, so I will be updating that soon. I also met with the Accessibility team and they are going to look into some of this to help create more accessible maps.
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