Considering how prevalent scams and actively malicious content posing as ads are across ad services in general, having an ad blocker is just basic online safety at this point.
I still see fake download button ads distributed via Google's own ad infrastructure to this day. I even reported a few that were taken down.
For all the AI prowess Google likes to brag about, why can't they make a simple "does this look like a download button?" detector? The scams are not that clever, most of them follow one of a small number of specific patterns.
What's worse is when corporations try to be funny put a fake download button and the entire ad is like "Wow can't wait to click this skip button" and they don't realize that sometimes youtube randomly makes those unskippable so it's just awkward dead air for 30 seconds.