You do end up having to add "custom configuration" which means putting nginx configuration into a textarea without any validation. So far it's just been the occasional service that uses websockets, you need to configure nginx to handle the upgrade.
Let's encrypt integration works well enough. It says it persists your Cloudflare api key for DNS validation for cert generation, but it just doesn't or I missed a volume to mount that wasn't called out through the Unraid template for NPM.
Yeah sure you could just do this all yourself you smart person you, but on my home server I just... don't want to. I want a collection of dumb GUIs that get me where I want to be, and this did that for my reverse proxy need. If it stops doing that I'll find something else, but that hasn't happened yet.