I use Aseprite for drawing and editing, and many of the assets start from my own pixel art. Sometimes I use Pixellab's Aseprite Extension (Inpaint Tool) on top of my existing work to experiment with additional details or variations. After that, i polish everything for game use.
So it's usually not just a text prompt generating the final result. Most of the time I'm building on top of my own artwork and using ai for small enhancements, then refining those changes by hand.