Youtube premium is ad free.
There's Nebula for some creators and Patreon for others, but not everyone has an ad free way to watch them. Also Patreon can really begin to add up.
And yeah there's that extension that can skip sponsored segments but that's blocking ads, not paying to avoid them.
You can't skip the sponsored segment if literally 100% of the video has HelloFresh boxes in the background, or if an important part of the video happens while the creator coincidentally eats a bowl of Keto cereal.
Or what about those LinusTechTip videos where Intel gives them $5k to build a dream system for an employee (Intel based, of course). I find those entertaining but they're really just 20 minute long Intel advertisements.
Videos don't have nipples around, or else they would get flagged, right? Do the same for unmarked ads. This is of course a handwavy way to propose a solution... the idea is that something could be done to improve the ad-free experience of viewers who pay. Otherwise, they'd better remain using the latest published version of Vanced, which even integrated SponsorBlock (again, pirates offering a better user experience!)