After researching for a few days I can't seem to find a definite answer to this question anywhere on the web. Does anyone have any experience in this area?
ActiveX is an old Windows only technology. You can't use it on anything but windows, consequently you can't use it in Xamarin which has to run Android and iOS.
Generally ActiveX should be avoided as it is being phased out in newer versions of Windows . (Dropped from Windows Store Apps & Internet Explorer in Windows 10