Hello @Mark Frost,
welcome to this moderated Azure community forum.
The IoT Hub is a cloud gateway for IoT devices where each device has its own registration and security identity.
The IoT Hub support multiple protocols to accomplish the device-to-cloud and cloud-to-device communication like MQTT, AMQP, and HTTPS (not recommended).
These protocols support the device twin abilities like cloud messages, direct methods, and device twin properties.
See this blog post for an example implementation.
There you will see a limited set of properties is supported.
If you want to make use of 'plain' MQTT and all the abilities the MQTT protocol offers (like using custom topics, topic wildcards, last will and testament), check out the Azure EventGrid Namespace MQTT support.
This is a 'plain' MQTT broker supporting both MQTT protocol V3.11 and V5 features.
Check out this blog post on how to use this new MQTT broker living in Azure.
If the response helped, do "Accept Answer". If it doesn't work, please let us know the progress. All community members with similar issues will benefit by doing so. Your contribution is highly appreciated.