It does that on Linux, too. Likes to mess with PulseAudio settings when you're not looking.
Exclusive mode is a bit like full-screen for GPUs. DirectX games can do things like override the output color management, gamma ramps, brightness, HDR mode, and even set the "white point" on some displays! Similarly, audio applications can take control of your audio devices in all sorts of ways if permitted.
While "full control" of a GPU is still useful, because we're not living in a utopia where all displays are 12-bit HDR all the time, audio has long ago passed the point where direct control delivers tangible benefits. Software mixing is more than capable of "keeping up" even with an absurd number of simultaneous streams at a quality level that vastly exceeds what the human ear can perceive.
I found that with Teams, it's more important to turn off direct control of the microphone than the speakers, but I do both just to be on the safe side...
The only pulse audio annoyance happening here is pulse audio itself assuming all my 3.5mm jack headphones have a microphone.
I have a wrapper script that installs, starts the meeting then uninstalls because unfortunately people use it and sometimes I need to contact them.
The biggest problem for me is having multicolored noise covering most of the Zoom windows/controls when I'm sharing a window.
Also, it takes like ten seconds to share or stop sharing a window.