Download win-acme pluggable, and the associated plugins (in our case, Cloudflare) and extract to c:\tools\win-acme\.
In c:\tools\win-acme\settings.json, set PrivateKeyExportable to true, and set the DnsServers to 1.1.1.1.
"DnsServers": [ "1.1.1.1" ]
Run wacs.exe as administrator.

Select M to create certificate with full options

Select 2 for manual input

Type in the full FQDN hostname

Press enter to accept the default friendly name.

Select 4 to make a single certificate

Select 6 to use Cloudflare DNS

Select 1 to type in the API key from Cloudflare, and then paste it in, and type y to save it, and then give it a name

Select 2 to use an RSA key

Select 4 to use the Windows Certificate Store (Local Computer)

Select 1 to use the [WebHosting] store for IIS

Select 4 to also use the Windows Certificate store

Select 2 to use the [My] store

Select 5 for no additional store steps

Select 1 to Create IIS bindings

Select 1 for the Default Web Site

Select 2 to start an external script

For the script file, type in:
Scripts\ImportRDSFull.ps1

Type as the parameter {CertThumbprint}
Select 3 for no additional installation steps
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