In order to be able to create an interaction, this option must be enabled in the Course/Video's Preferences.
Once enabled, the Annoto Widget will include the Interactions tab:
In the Interactions tab, click on the Plus button (bottom right) and choose "Create":
Select your preferred Interaction type:
True/ False
Multiple Choice
Multiple Answer
etc.
Once the Interaction type is chosen, click "Next":
Then define the settings of the interaction (Content, Settings, Preferences and Review)
Learn all about it in the next session - Interactions Creation Flow