Depends on the game. The answer for me is I'm not really interested in flavour of the month online shooter games so it's never been an issue but I know plenty of people who are and just continue to modify their VM until it's not detected - it's always gonna be something you can do to hide from the AC
VAC has a number of other triggers too but doesn't care about VMs in particular. I think everyone and their dog is an expert in not tripping VAC at this point
It's mostly those annoying ACs with kernel modules like EAC, BattlEye, ESEA etc. that do anti VM in an attempt to prevent cheat devs from 1. debugging the AC without at least a little effort and 2. having a clean OS but reading guest RAM from the host to avoid the anticheat entirely