This is the unit:
https://smile.amazon.com/gp/product/B07QNV8T31
You will have to watch their little video to see the nuts (more properly "jam nuts"). It's at the 4:38 mark.
Basically, you thread a small nut onto the valve stem, then screw on the sensor cap, then use a wrench to back off the jam nut until it binds against the bottom of the sensor cap. This locks the nut and sensor to the stem. In order to remove the sensor cap, you must first loosen the jam nut with a wrench.
On my rear dualies, it's impossible to get a wrench (or your hand) through the wheel cutout to work a wrench against the jam nut.
I thought about going to a tire shop and having them unmount the outside wheel and install the sensor on the inside and then put it all back together, but then if I ever need to add air I can't as I can't remove the sensor.
Based on what I'm reading here the jam nut is just anti-theft so today I'm going to install the caps with no jam nuts.
https://en.wikipedia.org/wiki/Jam_nut