keyboard = telebot.types.InlineKeyboardMarkup()
keyboard.row(
telebot.types.InlineKeyboardButton("Кнопка1", callback_data="btn1"),
telebot.types.InlineKeyboardButton("Кнопка2", callback_data="btn2"),
)
bot.send_photo(message.chat.id, photo='url фото', caption="Подпись к фото", reply_markup=keyboard)