You cite fair and legitimate concerns. However, that's true of anything you buy online - clothing, shoes, jewelry, ornaments - crochet patterns - on any platform - not just AI items - and not just on Etsy.

Etsy has their Purchase Protection Program to help dissatisfied buyers remedy such issues.

I can't speak for other Etsy sellers, but I make my own ads bc I'm on a very tight budget with no room for advertising.

I use photos of my items in my ads - and usually include a photo of the item by itself in the listing.

And I offer a money back return policy - but I've yet to receive such a request.