@vnp's code is solid and helpful, but his `stringify_state_helper` is a single-purpose function, and still leaves a degree of repetition and memory management in `stringify_state`. I'd rather have general-purpose `to_string` that takes printf-style arguments, allocates sufficient space for the converted result, and prints into that space, and returns the result:

    #include <stdio.h>
    #include <stdarg.h>
    #include <stdlib.h>
    
    char *to_string(char const *fmt, ...) { 
        va_list args;
        va_start(args, fmt);
    
        va_list args_dupe;
        va_copy(args_dupe, args);
    
        int size = vsnprintf(NULL, 0, fmt, args);
    
        char *ret = malloc(size+1);
    
        if (ret != NULL)
            vsnprintf(ret, size+1, fmt, args_dupe);
        return ret;
    }

In fairness, this does require a little more code, and the `v*printf` functions are a bit less known (and argument-list macros) a bit less known, so some may find it a bit more difficult to understand.

On the other hand, in exchange for that bit of extra investment, we get something that's more general, and works much more as I think most people would expect--for example, something like this:

    char *s = to_string("%d, %d", 1, 2);

Using this, `stringify_state` should turn out something like this:

    char* stringify_state(State* state) {
        Pet* p = state->pet;
        Settings* s = state->settings;

        return to_string("%lld %f %f %f %f %f %f %f %f %f %f",
                         state->last_update_time,
                         p->health, 
                         p->max_health, 
                         p->satiation, 
                         p->max_satiation,
                         s->milliseconds_per_tick, 
                         s->hunger_pain_per_tick, 
                         s->hunger_per_tick,
                         s->satiated_heal_per_tick,
                         s->pain_per_wrong_answer,
                         s->satiation_per_right_answer);
    }

#Other Points

Given the number (and length) of arguments you're passing, I'd prefer to see the arguments passed one per line as I've formatted them above, rather than a variable number per line to justify out to some particular right margin.