We have used the hex nut inserts in a production setting. Since all of our parts were punched on a CNC punch, we could easily implement the hex hole.
I've never seen that hex punching tool, that would be handy for these types of inserts.

We also found some specialized round nut inserts that had grippers on the head/top of body and those allowed us to use a regular round hold, but those grippers provided superior resistance to torque turning.

I believe this is the one we were using: https://fasteners.sherex.com/category/optisert-series