Chords and layers, my guy. Much in the same way you type a capital letter with a combination of two keys (shift + letter), people using smaller keyboards do the same thing for any key you deem “missing”, just with more keys being pressed. There’s even functionality where each key behaves differently depending on whether you tap or hold it.
Technically, you can have only 10 keys (one for each digit on your hands) and still get 2^10 = 1024 unique actions! Forget letters; you can have have whole words encoded in those keys, and voila ~ that’s basically stenography!
If you don’t like it, that’s okay! I’d never be able to use one myself either, but the people who can use it do like it; and besides, it’s all good fun to see what people can do with these layouts.
The same way creative professionals learn keyboard shortcuts for software like Blender, Photoshop, or Premier: practice.
It seems daunting, but honestly it’s not that difficult to adjust to using layers or chords on a smaller keyboard, especially when you can assign all those inputs to any key combo you want.