Backups are there to provide a business continuity in wide range of disruptions. What you want to protect your business from is up to you, but typically you need protection from all things OP mentioned.
1. Test and encrypt backups.
2. Don't get hacked. Defense-in-depth philosophy and rigorous, routine social-engineering training/testing. If you get hacked, it's usually game over. Defend systems like the business depends on it because it does.
3. Limit exfil: extra security for PII, exfil detection, and [HN]I[DP]S.