Hi @BridgeWater,
To access work items via Azure Devops APIs, you need to to add 3 API permissions in app registration - vso.work vso.work_full vso.work_write.
To get the OAuth token you need to pass the below URL in the scope parameter:
https://app.vssps.visualstudio.com/.default
You will get the user access token with this scope.
But if you pass vso.work vso.work_full vso.work_write while calling the auth API, you will get the below same error:
Hope it helps, thanks!