Hi , @ebels
According to your description, you want to use the Patch() in Power Apps to populate your Items columns in 'IT Requests' list from the [Item] field in the 'Order Items' list. And the [Items] is a lookup type columns in your side .
I test it in my side and here are the steps you can refer to :
(1)This is my test data:

(2)We can use this code in Power Apps Buuton-OnSelect:
ClearCollect(Spdata,'IT Requests');
ForAll(Spdata As IT, Patch('IT Requests' , IT , {Items:
ForAll( Filter('Order Items', Title = IT.OrderNo) As test,{'@odata.type':"#Microsoft.Azure.Connectors.SharePoint.SPListExpandedReference", Id:test.ID , Value: test.Item } ) } ))
The 'Id' is the ID column in your LookUp table , and the 'Value' is the related Lookup Column when you create this lookup column.
And the result is as follows:

And for the more information, you can also refer to :
Solved: Powerapps update LookUp Column (multi-select) - Power Platform Community (microsoft.com)
Best Regards,
Yueyun Zhang