Pictures have the issue of "how do I get them". Midnight Idle (found here on Itch), uses AI pictures quite intelligently, that they don't have the usual issues with them, but people have issue with AI pictures on Steam.
Some people figure out ingenious ways of generating images, like justkevin did with Starcom: Unknown Space, but that requires specialized tools and a lot of patience.
In general, most people either have to get royalty free images or some artist that wants to make a start in game development, to get the images you might need at anything of a reasonable cost. Like, you might think that a wage of $60,000 isn't much per year, but its a lot of money for a small indie to pay for 4 months of effort ($20,000). And as most small indie games, don't easily make $10,000, for their first game, as net profits, its pretty demanding to require images.