It is possible to bypass Play Integrity on most devices (even at the "strong" level) using a sewing needle.
Specifically, you poke the data lines of the memory bus to induce bitflips, much like I described in https://www.da.vidbuchanan.co.uk/blog/dram-emfi.html
This is trickier if your device has the DRAM mounted directly on top of the CPU, but still possible - you'll need to do some BGA rework to get a wire soldered to one of the DQ lines.
Once you get a physical memory read/write primitive, you can start patching the kernel. Play Integrity does not detect this, since it only attests the state of the kernel at boot. I chose to patch out the permission checks related to ptrace, allowing me to inject frida-gadget into running apps, and to inject shellcode into pid 1.
The initial exploit is pretty unreliable, and usually takes a few reboots to hit. But once it lands, the device is pwned until the next reboot - like a "tethered jailbreak".
I tested this on a Samsung A06 because it was the cheapest device supporting Play Integrity I could get my hands on, but there's no fundamental reason it shouldn't work on any other device, including flagships. Some mitigations would require a different exploit strategy (e.g. memory encryption), but the fundamental flaw is still there.
Much like DRM, the point is that we shouldn't have to fight this BS in the first place.
Play Integrity will only get more advanced, though