My 12 year old just is not learning...or disrespect?

12 year old boy, he will be 13 in May. Dx'd severe combined adhd. On guanfacine and vyvanse, these have helped immensely with anger outbursts! However, no matter how many times we explain, no matter what we do (take away video game/tv time, outside time etc.) He will not do anything we ask, he claims he doesn't know how to do them (even if we have shown him), such as scraping his plate and rinsing it, peeing IN the toilet, throwing his garbage away (he will just leave it wherever it is), leaving his clothes in a pile after a shower rather than putting them in the laundry basket thats literally right there etc. But it's more than even just that, he is rude to his friends and to us, like, he thinks he is joking but goes too far and just cannot seem to control his mouth, he argues, even if he knows he is incorrect, it's as if he cannot control what comes out of his mouth. He has lost many friends over this, and I've tried to help him understand where the "line" is. He gets highly inappropriate, and that's been an issue for years, he has made inappropriate comments towards his female cousins and friends and has even been caught trying to kiss them (again this has been going on for years), now calls women "hoe's and bitches" thinking it's a funny thing. I'm growing more and more concerned because he just cannot seem to learn, or doesn't care. I am at a loss, I am so frustrated.
Does anyone have any advice? I just don't know what to do anymore.