I've been doing this in a personal project. I ended up settling on ts-node as the fix -https://www.npmjs.com/package/ts-node

Frankly - it does pretty much everything I want it to. I can write code in Typescript and have it feel like there's no build step at all.

I can use ESM everywhere - frontend, backend, buildscripts, random tasks, etc - and have no problems.

That said - It's not a legacy codebase, and it's only getting hobby level usage (currently serving a few requests a second), so there might be hurdles I'm just not hitting.