You'll get a recorded screen-share going through your account, plus a written list of fixes in order of how much they'll save. You can keep both and do the work yourself if you'd like.
We start with conversion tracking, since everything else depends on it. Are the right actions counted? Is anything being counted twice? Is enhanced conversions on? Then the search terms, to see how much is going to irrelevant searches and which negative keywords are missing.
After that come campaign structure, match types and bid strategies, and whether they suit the amount of data you have. We check whether Performance Max is picking up your brand traffic, look at ad copy and assets, and see how your landing pages perform on a phone.
Finally, location and schedule settings, and whether leads are reaching your CRM with enough information to judge which campaigns bring in good ones. If you run Meta Ads too, we'll look at the Pixel, the Conversions API and lead form settings as well.