We were told that he can basically eat anything as long as he balances is out with the right amount of insulin. Is this wrong? Or is this just to start with?
It's broadly correct, but your son will find with experience there is more to consider.
In terms of blood sugar control, then yes, it's fine provided whatever is eaten is offset by the right amount of insulin.
However, that doesn't mean it's a free pass to eat whatever he likes. The basic common sense diet rules apply. For instance, eating a whole chocolate cake is a bad idea for a non-D. Being able to inject enough insulin to cover the cake doesn't mean it's a good idea for your son either! You will already know this but it's worth reiterating as having been a teenager on MDI myself, there would be times when I would use the fact I bolused to justify some pretty poor dietary choices. Good habits take time to bed in.
It is also worth noting that insulin technology still has not caught up with the wondrous invention that is the human body. For instance, I could eat a 50g pack of sweets, carb count roughly 45-50g. To me, that'd be technically around 5u of insulin to match. However, what would happen would be this. I would inject and then eat the sweets. The sweets would hit my blood sugar within 10 minutes and prop me up from say 5mmol to 15-20. My BG would then stay that high until around the 45 minute mark where it would start to go down. Probably after 2 hours, I would hopefully be back to normal. Except then I've got nothing left in the tank and the insulin has another hour to run.
So in other words, over a four hour period from eating the sweets, my BG will be extremely high for at least half of the time, normal for about a quarter of the time, and then potentially too low for a quarter of the time. That is obviously not good control.
There is also an extra issue that the more insulin you take, the more fat metabolism you inhibit and the more fat you are likely to store. Foods like chips and crisps don't make people fat because they contain fat. They make people fat because in non-Ds they trigger an insulin response to metabolise the high carbs (by the way, excess blood sugar that isn't immediately needed is turned to fat by insulin) and then the fat content is simply prevented from being metabolised by the presence of insulin, so these foods essentially give you a double hit.
I guess the point I'm making is yes, insulin will allow your son far more freedom to eat what he likes and the idea that he can eat anything and cover with insulin is broadly true. However, given the way medical insulin works, it remains absolutely vital he makes sensible dietary choices 90% of the time.
It also remains absolutely vital he lives as normally as anyone else his age and his insulin should fit around that, rather than vice versa
