multitouch+stylus screen, plus the windows ink demo app https://www.microsoft.com/en-us/garage/profiles/sketch-pal/

its low latency, can do multiple layers, and its easy to pick out a standard set of colours to draw with.

It lets me make good rhetorical diagrams, and I've also used it for drawing quick mockups to get genai to make webpages

also, Quip as a design document/review tool. Its fantastic having a design review where you get comment threads going along different parts of the requirements and design, that you can then focus on in discussion time. it also lowers the barrier to giving feedback, so newer devs can ask questions without feeling like theyre taking up valuable meeting time