Got the answer from Iko Rein who produces the Telemetry software.
"So the F1 games (since F1 2018) have been able to report the buttons pressed in game. The buttons are reported as a 4-byte Integer, i.e. it can show 4x8=32 different buttons (pressed at the same time) via a bit mask.
The buttons from 1-20 are listed as the normal PS/X-box controller buttons, like CROSS or A etc, but that does not limit, what you can do with them. They are just "names" on the mapping. Then there are buttons 21 - 32, i.e. 12 buttons with no preset "name", the UDP 1 - 12 buttons are used for these.
If you want to e.g. use a custom button box, or your wheel has more than 20 buttons, you can assign an in-game action to these buttons. E.g. if you connect a button in the wheel to 'UDP 1', then when you press the button in the game, the game reports then the associated value. This allows bit more control e.g. Tool developers to make things happen in their tools, or you can in-game bind the 'UDP 1 button' e.g. to 'PIT limiter'.
At least someone knows!!