Yes, you need the OpenSC libraries from https://github.com/OpenSC/OpenSC/wiki/
Build instructions are under /wiki/Compiling-and-Installing-on-Unix-flavors
You also need to add a polkit rule to grant access to the Librem key. https://ajmartinez.com/tech/posts/202123-001-fedora-pcsc
Then in Veracrypt preferences, under Security Tokens select the /usr/lib/onepin-opensc-pkcs11.so library or whatever path you installed OpenSC to.
Under the Keyfiles tab, you can unlock and manage token files on your Librem key.