Creating pictures in Excel is a bit complicated, mostly due to the many, many different tweaks that can be done in the picture. As of 10/22/2013, options are fairly limited -
Two-cell anchors - specify which cell the picture starts (at the top left) and which cell it ends at (in the bottom left). Offsets also available by specifying an xOff and yOff on each parameter.
One-cell anchors - specify which cell the picture starts, and the width/height of the image.
Absolute anchors - specify the offset of the image, and the width/height of the image.
OpenXML Drawings have an odd (understandable, but still odd) positioning system. Use the pixelsToEMUs method available in the Positioning.js to turn a pixel amount into EMU's, which is what is needed for any offset specification.
Note Please note that pictures must be provided as base64 format, you can look on the internet on how to do that or if you're using ViteJS then look at the Vite loader plugin at the end of this document.