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First check that what you want to run has been marked as 'Runnable' - if not, you cannot run it at all.
If it has been, you can run Forge and Fabric assets by installing the respective modloader and putting the binary in your mods folder,
Executable assets can be run by simply launching the executable file they come with,
Injectable assets must be injected through an external tool (See 'tools' category for a DLL injector) and
Version assets must be run by putting the files in your .minecraft/versions folder, after which they'll show up as a version in your Minecraft launcher.
First and foremost our archive is an archive and not a page to search for cheats, so if something released with malware or telemetry originally, we will not remove it for the sake of preservation. That said, entries marked 'Safe' are safe to run.