Pixel aspect ratios are not always 1:1. Fonts have character height to width ratios which are all over the place and a terminal which must adapt any character cell to any region of an image pixel perfectly is way more difficult than it needs to be. Unless you're Casey Muratori, probably. then there are things like display scaling, which, ideally, the terminal application itself shouldn't need to know anything about in order to render correctly. What good is a terminal that renders pixels exactly if the OS can then magnify the window so that you lose the pixel "perfection"?
I don't like the Kitty protocol described in this post, either. The Windows Terminal people are thinking about this, believe it or not, and they are the ones that convinced me that existing methods are insufficient. We need yet another standard for doing this. One that can adapt to video display technology of the 1990s, at least.