[0]: https://tic80.com
[0]: https://tic80.com
Certainly, you can build your custom device. Still, it is sort of derailing the original intention if you are making a game or participating in the demoscene and would like to focus on the development (or learning) aspect rather than porting and hardware.
Game development is already hard. It could be a nice cherry on top to run it on the physical device; however, emulators are great to get started.
That's not to say it can't be done. I have seen demos using everything from custom code and circuits using an ATtiny to people using VGA libraries on higher performance microcontrollers, but that's not everyone's cup of tea and would likely be hard to implement around a game jam.
Beyond that, I suppose it is also a some way to prototype. Celeste[0] was originally created as a PICO-8 game.
[0]: http://www.celestegame.com [1]: https://www.lexaloffle.com/bbs/?tid=2145
You either settle on a hardware that's basically an embedded linux that's way overpowered and runs hot/drains battery OR you let go of the ease of use and get dirty with embedded development tools. If you look up some GBA homebrew you can quickly see why this will remain unpopular.
The third and most ridiculous option would be fabbing a custom low power SoC that has an embedded gpu specifically designed around the pico8 limitations and some extra opcodes that accelerate luaJIT.