Without the additional constraints manifest v3 puts on what code an extension can run at runtime, an extension author can just slip some "grab some code from a server I control and eval it" logic into their extension, which Google can't vet. That makes it possible for an extension that was fine yesterday go to "harvesting your PII to send to a company that is building an AI based on your click frequency" today with no change indicated; just a silent "Oops I'm malicious now" shift.
All cards on the table: Google does a not-great job of protecting against intentional malicious changes last I checked, i.e. they'll pass through a lot of new extensions and extension updates that do shady stuff behind the scenes. But without some lockdown on arbitrary code execution (which Mv3 provides), the problem is theoretically impossible to solve.