When adding accessibilty to the rating view I felt there might be a better way to do it. Instead of keeping each star as an individual button I thought it might make more sense to access them as a set.

You can use accessibilityAdjustableAction() to give actions to swipe directions and basically turn any view into an adjustable control.

Here's my full code for RatingView:

import SwiftUI

struct RatingView: View {
    @Binding var rating: Int16?

    var label = ""
    var maximumRating = 5
    var offImage: Image?
    var onImage = Image(systemName: "star.fill")
    var offColor = Color.gray
    var onColor = Color.yellow

    // Special rating string for voice over
    var ratingString: String { 
        if let rating = rating {
            return "\(rating) star\(rating == 1 ? "" : "s")"
        }
        return "No star rating applied"  // A helpful note for when the rating is nil
    }

    var body: some View {
        HStack {
            if label.isEmpty == false {
                Text(label)
            }
            ForEach(1..<maximumRating + 1) { number in
                self.image(for: number)
                    .foregroundColor(number > (self.rating ?? 0) ? self.offColor : self.onColor)
                    .onTapGesture {
                        self.rating = Int16(number)
                    }
            }
        }
        .accessibilityElement(children: .ignore)  // All views inside the HStack are ignored for accessibility
        .accessibility(label: Text(label))  // Label added here
        .accessibility(value: Text(ratingString)) // Value added here
        .accessibilityAdjustableAction() { direction in  // This function allows you to run code based swipes up or down
            guard let rating = self.rating else {
                self.rating = 3
                return
            }
            if direction == .increment {
                self.rating = min(rating + 1, 5)
            } else if direction == .decrement {
                self.rating = max(rating - 1, 0)
            }
        }
    }

    func image(for number: Int) -> Image {
        if number > (rating ?? 0) {
            return offImage ?? onImage
        } else {
            return onImage
        }
    }
}

struct RatingView_Previews: PreviewProvider {
    static var previews: some View {
        RatingView(rating: .constant(4))
    }
}