This study investigates the time-use patterns of students with learning disabilities during digital mathematics assessments and explores the role of extended time accommodations (ETA) in shaping these patterns. Using latent profile analysis, four distinct time-use profiles were identified separately for students with and without ETA. "Initial Focusers" spend more time on simpler initial items and less time on later, more difficult items, exhibiting high omission rates and low performance. "Rapid Progressors" complete assessments quickly but exhibit shallow engagement across all items, achieving low performance. "Diligent Time Maximizers" allocate time effortfully across items but often run out of time on the last two items when ETA was not granted, achieving the second-highest scores. "Efficient Prioritizers," excel in strategic time management, score the highest, and report strong persistence and interest in math. The findings reveal that ETA supports students who adopt meticulous strategies, such as Diligent Time Maximizers, but does not universally address the challenges faced by other profiles. This study underscores the need for tailored interventions and accommodations aligned with individual time-use profiles to foster equitable and effective learning and assessment environments. [This paper will be published in the "Journal of Learning Disabilities."]