The Harlequin Tuskfish is my all-time favorite fish and I hadn't kept one a couple of decades as I haven't had a FOWLR system. But when I needed to reboot my 120gal reef system, I decided that I wanted to keep a smaller tusk in my mixed reef.
The tusk will make quick work of any shrimps and/or crabs in the reef. I do have Banded Trochus Snails in my tank which fare well against the tusk. The tusk doesn't bother the snails, however if a snail falls and cannot get flipped back over, the tusk will take the opportunity and make a meal of the snail. I have no urchins.
I don't plan on keeping smaller fish in this reef. My tusk is still small, but I don't want the risk of it hunting any bennies, gobies, basslets or dartfish.
The tusk doesn't bother any of the corals. It does however like to pick up pieces of my substrate (TLF ReBorn media) while creating hiding spots and drop them wherever it feels like; sometimes on top of LPS corals on the bottom.
I am also going to avoid adding any clams; another risk not worth taking.
Tusks are gorgeous fish, but they do limit your livestock selection.
Good luck.