I'm using stock Android with a bunch of F-droid apps and no Google account. I've never installed anything from Play and don't feel like I'm missing anything.

Aurora store make it pretty seamless. Used to run my Samsung without any account, no Google nor Samsung and things worked perfectly.

On some devices I run custom distributions (mostly LineageOS), others I just root and de-fang by removing all objectionable content including the Google bits. In all cases I put on F-Droid with a few configured repos to get the applications I want. On a few devices I also add some proprietary apps which are more or less mandatory - electronic ID (BankID) being the main one - either by manually installing it or through Aurora Store, an alternative play store front-end which does not require a Google account. No Google, no problem and no real hassle. My current main phone - a Xiaomi Redmi Note 5 Pro - is 8 years old, I already have a replacement in a drawer but have not configured it yet because I first want to make a cover for it. Even though it is 8 years old it works fine, the battery holds for 2 days and all applications I need still run on it. The oldest device in use is 15 years old and also works fine but it can no longer be used as a phone since 3G was switched off where I live.