I absolutely realize this is an edge case, but…
I don’t have a very “fixed” schedule. There are days when I have to be up at 5:00 AM. There are days when I wind up doing late-night server maintenance and absolutely don’t want to be up until 9:00 or 10:00 AM. There are some days when I’m taking care of my neighbors’ dogs and I need to be reminded a few times a day to get upstairs and let them outside.
Each of these has a couple of alarms (5:00 AM, for example, alarms me at 4:45 and 5:00 just in case I manage to dismiss the 4:45 alarm - I never miss the second one).
There might be half a dozen different groups of alarms I need.
I’m currently doing this with a huge list in the built-in alarm manager on iOS, but it’s a lot of hassle to check/uncheck/label/etc.
Is there a way to put these in groups, and activate them on a day-by-day basis? I.e. tonight I need to be up at 5:00 AM tomorrow - so I click a button on my phone and pick the 5:00 group.
Is that possible? Or am I crazy? 
the trouble with third party alarm programs is this: they have to be running and front and center to hear the alarm. The built in Alarm can break through everything. Third party alarms must be the focus app or you may not hear it.
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You might try the Due app. It’s got nagging notifications that will keep repeating until you mark it as done or snooze it. Due to iOS 11 limitations, Due app can only nag you up to 10 minutes and that’s it. I use it to trigger a daily reminder at 4:45 pm to remind me every 15 minutes to do my End-of-The-Day review. Then I have it set to Wednesday at 7 pm to take the trash bin to the curb. It’ll keep nagging me to make sure I take my garbage out and mark it as done.
Available for iOS and Mac
It is on the OmniFocus Road Map that nagging reminders will be coming soon in an update to OmniFocus 3.
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That looks like a possibility - I’ll have to check it out. Thanks!
Due exists for all iOS devices and all Mac devices and syncs via iCloud or dropbox. I use if for my drop dead appointments every week