Requiring a human-in-the-loop for final, non-prerelease publication doesn't seem like that onerous of a burden. Even if you're publishing multiple releases a day on the regular (in which case ... I have questions, but anyway) there are all sorts of automations that stay secure while reducing the burden of having to manually download an artifact from CI, enter MFA, and upload it by hand.

You can still have a step that requires a certain user/group to sign off, and you can still enforce that those users have MFA set up. Almost any serious shop that expects to pass audits already does this in some form or fashion before pushing code to prod.