I'm actually asking this question as I have recently struggled to get SQLAlchemy working with SQL Server ODBC Driver 18 on a Mac and have not seen an up-to-date description that worked.
NB: 'TrustServerCertificate': 'yes' is very key for a lot of setups and knowing where and how to express it in the connection string is not immediately obvious.
This works (as @ 7 Sep 2022) with the MSSQL ODBC driver instructions at: Install the Microsoft ODBC driver for SQL Server (macOS)