Come up with a proposal on how to change something thats bothering you. Either put together a doc and ask for feedback on it, or make more than 1 proposal.
Bring it to your 1:1. Talk through it with your manager. Work out where you need support from them (Be it asking for time to focus on it, finding someone else in the org to help you out, etc.)
'The system is too slow', 'Person X has poor quality Y', 'Other business unit / eng team / etc. ideas is flawed we should not do it or do it differently'
This helps manage your manager, and make the meeting meaningful for you and most likely your manager.
Check out https://medium.com/@sbourke/getting-more-from-your-1-1s-8f71... , it has a few things from the playbook link as well. I have a more elaborate version I'd give to my direct reports. 1:1s are great if you do them well.