I2c problems with ItsyBitsy RP2040

Which one exactly?
The obvious cause would be that the library isn't compatible with the RP2040 core, which wouldn't be a big surprise to me. You could try a different library to see if that works, or alternatively implement very basic functionality in a self-made sketch to verify you can 'talk to' the INA3221 from the RP2040. I'd probably go that route myself but I'm not sure if it's within your skills to do so.