Simply reviewing the PKGBUILD is not enough for the same reason reviewing a Makefile is not enough: You need to review the source code for _everything_ that is being downloaded and executed on your machine. For AUR packages, that means not just the PKGBUILD but the full source code for the program it is building and the full source code for any of its dependencies.
Hypothetical example: you wouldn't have caught the xzutils exploit by reading the PKGBUILD.