When it comes to Surface Pro tablets I find that going with this Kernel helps a lot:
https://github.com/linux-surface/linux-surface

Seems that LTE and Camera isn't working properly but that the rest works:

https://github.com/linux-surface/linux-surface/wiki/Supported-Devices-and-Features#surface-tablets

This isn't a distro thing, it's generally the Desktop Environment, though with the Surface devices, there is a custom kernel lots of people use that has some extra drivers for the rest of the hardware, so look for that. You can use it with any distro.

As far as the DE, Gnome has better general touch support over others right now, so it's probably going to give you the experience you're expecting. Every art app I've tried with a pen has great pressure support.

I've had 0 issues running touchscreen and pen on Mint, and SAI can just run on bottles/wine, right?

https://github.com/TibixDev/sai2-guide

The solution on each distro is mostly going to be the same. Run sai in a bottle and edit the config.

Mint delivers a flatpak package of bottles, which is suboptimal, but can be fixed using https://www.virtualcuriosities.com/articles/1911/bottles-doesnt-work-on-linux-mint-because-its-a-flatpak

I'm coming at this from another angle, & your being stuck in an MS-Surface may break it, but please try UbuntuStudio, on something: it augments Ubuntu-family with an entire sea of fixes for creatives.

I've no idea how to get a kernel patched to work with such hardware, sorry.

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I have used Pop! which is basically Ubuntu but very polished and customized to enhance what’s already there. But as others said it’s not strictly a distro thing it’s Desktop Environment and also the graphics system I’m probably not using the right terminology. But Wayland is very good with touchscreen and I’ve read that X11 has some support as well (?).

I use Mint, and a drawing tablet.

I know this can be a problem with Huion tablets, since their drivers are closed source. I bought a Wacom tablet for this exact reason, their firmware is open-source, and so it's bundled into Ubuntu's software and all of its forks.

I'm sorry that there isn't more I can tell you. I could only afford to buy a high quality drawing tablet once, so I wanted to make sure the firmware was compatible with Linux. If you get very frustrated, you can likely find a secondhand Wacom on eBay.

Your exact surface pro isn’t there yet.

Switch to win 10 21h2 iot ltsc using massgrave and you can wait for linux support to get right till 2032.

Looks for Linux drivers for your device, OS is not the issue