I'm curious, and hope you or somebody else might be able to answer this: is it a single adjustment for each thing, where they just set it to always adjust by X ratio, or does it vary (enough to matter) as it orbits, such that the adjustment needs to be constantly varying slightly?
For the GPS satellites, their time signals are constantly compared with ground clocks, and adjustment signals are sent up to the satellites as needed to keep their clock corrections in sync with ground clocks.
I'm not sure what, if any, adjustments are made to clocks on the ISS, or how they're done.