Asian Nation-State hackers use fileless RAT for their hacking campaign
securityaffairs.co
securityaffairs.co
So, quite a number of files and system calls involved that permit to recognize and react to this attack.
An example of true "fileless" attack would be the one demonstrated by Conficker, where an infected computer attacks by brute force password guessing the other computers on the same network, gains access to the new machine and then runs the virus code without storing any files on the local disk.