Root users like myself use tools like AdAway to managing hosts blocking. This will help cover a lot of ads in apps as well. You also have alternative WebView implementations like Bromite (although I wish it were easier to install and worked on Android 10) that can give you ad blocking in apps using web views too.
This is also missing the part where you can run Android without the Play Store using microG and F-Droid + Aurora. It's not a huge number, but there are still a lot of people blocking ads in one form or another--even if it's as simple as using Firefox or Brave for basic browsing.