I know some of family don’t because they mostly rely on mobile devices and devices like Chromecasts where installing ad blockers can be a challenge. They don’t use traditional computers.
They know apps like NewPipe exist but the effort to port things over or not get recommendations is too much for them.
I do use ad blockers and open source front ends/software/alternatives. Ex. AntennaPod instead of Spotify for podcasts and Linux instead of Windows because I didn’t like ads in the start menu (amongst numerous other things).