I agree with making accessible controllers with special layouts and allowing custom control bindings to accommodate those who are differently abled.

Those can be accommodated without meaningfully altering the game. Changing the gameplay is different however. Not that adding more difficulty options is a bad thing, I don’t mean to disparage anyone by calling it fake accessibility, just that I don’t think it’s the same as other options because it fundamentally changes the experience compared to other options that I considered “real”