ManageEngine Patch Manager, prior to them fixing it, had an issue that would populate this folder with hundreds of thousands of tiny files over time (which took up actually a significant chunk of space thanks to how NTFS works RE metadata vs data)
To clear it out (once the fix had been rolled out, not sure which update) I’d cleared it without issue using the following in an administrative command prompt:
DEL /F/Q/S/A:S *.* > NUL
Be very careful where you use this - make sure you’d in SystemKeys