How do you guys draw icons?

To those of you who develop apps for Apple platforms and are totally blind, how do you draw your icons? Most of the symbols are available in the SF Symbols collection so those are not a problem. However I wonder how you are drawing icons to represent your apps in Finder, Launchpad, Springboard, Spotlight, and of course, the App Store. Do you request assistance from freelance artists? Do you just use AI? And how do you evaluate the final result?

I have a swell paper embosser, which can help with these things, but I doubt that most people have this kind of hardware, so I wonder what you do for icons.