Usually one button in the end is some vaguely stated "accept all spying" too that sounds like you don't accept. E.g. "Accept all choices" or whatever.

This is easily fined for non compliance, however the process is currently very slow but it depends on the country you signal it.

Those dark patterns are not GDPR-compliant. GDPR says, "it should be as easy to say yes as it is to say know" and on top of that those huge lists do not present informed consent.

NOYB has a bit on that: https://noyb.eu/en/where-did-all-reject-buttons-come