I know Austin flies, so the following is more aimed at him if he's reading.
With moderate care you can totally fly a Cessna 172, 152 etc. controlling the pitch just through the trim. Change the pitch wheel, and it affects the elevator, which affects the wing. The whole aircraft then settles down to the desired AoA which given a power input will cause the aircraft to climb or descend.
The specific short-coming of most sims is that trim input should settle the aircraft to a desired AoA reasonably quickly (subject to mild phugoid oscillations - mild pitch cycling) but it just never really does.
Typically, any decent pilot can trim the aircraft to the desired speed at some rpm, then just fly using light pressure on the controls adding or reducing power in small increments as needed.
Under say IFR, the workload can be quite high, and anything you can do to reduce the attention needed to maintain chosen course is critical.