@maxthefox apart from already suggested good options of checking if the situation is slightly better with SBC (in pavucontrol there is a switch to flip between codecs), have you checked how high is the load? (for some funny reason I do have the problems like yours with pulseaudio, but not with pipewire + wireplumber under high load). sometimes bluetooth works much better just if you switch to cable, because the card itself is shared with wifi module.
as has been said already, it's a mess, good luck!