It turns out that MacOS Tahoe can generate and use secure-enclave backed SSH keys! This replaces projects like https://github.com/maxgoedjen/secretive

There is a shared library /usr/lib/ssh-keychain.dylib that traditionally has been used to add smartcard support to ssh by implementing PKCS11Provider interface. However since recently it also implements SecurityKeyProivder which supports loading keys directly from the secure enclave! SecurityKeyProvider is what is normally used to talk to FIDO2 devices (e.g. libfido2 can be used to talk to your Yubikey). However you can now use it to talk to your Secure Enclave instead!