My moms old and gets confused with 3 picos. So Iām using pico for the lights. For the fireplace and fan I want a 4-5 button. On and off, then up and down. Thank you
There are four button Picos with those exact labels if that is really what you're after (except the on/off would normally be lights--they have other choices, often more expensive, but I don't think any for fireplaces). For example, check out the PJ2-4B-GWH-L01 model.
Otherwise, the first thing that comes to mind is the Zooz ZEN34. It's a paddle, so only two buttons, but you could use hold for up and down if that works, sort like most smart dimmers also work these days.
There may be other options out there someone else can think of.
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There is also a 2 button pico that supports multitap on hubitat.
There are a wide assortment of Pico remotes. These documents show most (all?) varieties of them. The only bad thing is the more niche ones are $$$ compared to the ones you get in the kits.
Right, but question was for four buttons. 
The one I mentioned is a 4-button model with on/off and up/down, and it would also support double taps if needed, FWIW.
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My preference is Pico like everyone else, but so as not to totally ignore your request, I also have one of these Aqara Opple 6 button remotes. Super reliable and very inexpensive to purchase.
There used to be an HE driver, but I'm not sure if it still works properly. I've never directly connected my Opple 6 button to HE. But if this is at your place where you just spun up HA so you could use HADB, then you can just add an inexpensive Zigbee controller. I've read that the Sonoff controller is decent, and I have never had a moment of trouble with anything connecting to my ConBee II.
It's pretty simple to create virtual switches for toggle, and auto-off virtual switches for button pressses, and then share them to HA via the HE>HA integration. Then just configure it to activate the switches in HA. I use mine for triggering my Delta VoiceIQ module. There are Blueprints for both ZHA and Z2M available, so it's super easy to setup.
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There is also the Hue controller
https://www.bestbuy.com/site/philips-hue-dimmer-switch-white/6454394.p?skuId=6454394
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