Like can a games default sort be like:
5 hours 467 items
6 hours 467 items
2 hours 465 items
5 hours 465 items
2 hours 12 items
5 hours 6 items

Like a Highscore based category? Yea i guess. If you edit a category you made, press the button that says time esc or something like that.

Well yes but if two people get the same score then sort it by time

Then no. I dont know how to do that. I dont think its possible.

then how would you tell apart two people with the same amount of items?

its a tie then. there are multiple games that have categories where tons of people tie

The way some leaderboards have arranged for this sort of thing is to manually sort each run by the criteria they want, setting the time as 01 for the 1st place run, 02 for the 2nd, and so on. For an example, see the damageless category in Rayman 1, where the primary sorting method is fewest hits taken, and the time of the run is the tiebreaker for players who took the same number of hits.

There's currently no way to do this automatically as far as I know.