A limited set of actions can assigned via macro commands. Incompatible actions are ommited from the generated macro. Also note that Macros are limited to 15 lines each.
MMO Mouse, most actions on 2 hotbars for easy Ctrl toggling
Rough layout based on my other caster hotbars. I use 1-5, F1-5 and 2 side mouse buttons.
Rough draft of picto bars
https://imgur.com/a/Eym6nDe