In the case of macOS, this is no longer true - when Apple finally kicked Carbon fully, Qt (IIRC, in 5.13 or something? 5.12 and prior used HIThemes, which was... showing age) switched to rendering true AppKit behind the scenes. There's a few custom controls where they render their own, if no AppKit equivalent exists, but otherwise it's AppKit all the way down.
As someone who used to decry Qt as not native, I'll be the first to admit it's fine now - if something looks "off" on macOS, it's probably moreso the implementing the author doing something different than the underlying framework.