The native extensions are fine but I don't have good experience with any third party extensions, so far tried Timescale, pg_lake, citus, and pgvectorscale. They look very appealing but it's usually a trap as you can't get the value without using the vendor's cloud offerings.

I think if you grow enough to look for these extensions, it's usually better to bet on purpose-specific tooling. For example, I use DuckDB/Iceberg combination extensively for columnar data and connect DuckDB to PG when I need it.