I have the four corner active air suspension on my RAM 1500 and had similar questions when we got our trailer a few years ago. What you want to do is temporarily disable the suspension before setting up or adjusting the hitch. On the RAM there is a setting called "Tire Jack" mode that completely disables the suspension.
For the initial setup I measured height from the ground to the top of the coupler with the trailer level. Then I adjusted the ball height on the hitch to be about 1-1.5" below that measurement. This ensures that later when the suspension is re-engaged it won't lift the tongue above level which can cause instability. A little nose down isn't a problem and is what I prefer for my setup.
Once the initial hitch height is set drop the tongue on the hitch and proceed to perform the weight distribution adjustments. You can measure the difference in front wheel well height before placing the tongue on the hitch and after and adjust according to your tow vehicles recommendation for front axle load restoration.
Once the weight distribution adjustments have been made you can then re-engage the suspension and it will level and remove any remaining sag in the rear. That won't really have any effect on the weight distribution, at least not that I've seen. I scaled mine with weight distribution engaged and with the suspension off and on and didn't see a difference in the axle weights.
Going forward I would continue to disable the suspension any time you are going to hitch up the trailer as well as unhook it. It can be a challenge to lift the tongue off the hitch when the suspension keeps raising the rear as the weight comes off it.
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TT: 2019 ORV Timber Ridge 23DBS, Blue Ox SwayPro 15K/1500
TV: 2019 Ford F-250 XLT SuperCab LB, 6.2L, 4.30/e-locker, 4x4, 164" WB, RoadActive Suspension, 3216 payload
TV: 2014 RAM 1500 Big Horn CC (Traded in)
TT: 2015 Jay Flight SLX 195RB Baja Edition, Andersen No-Sway (Traded in)
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