They expose a kernel API to allow games to verify the state of the system, and they're knowingly installed by the user.
The real solution, and not the hack Riot uses, is for Kernel to provide an API for anticheats, like it does for everything useland.
How does the anticheat then work? Corewars. It's a cat and mouse game between the cheat provider and the game developer.
One would need a secure base layer, where also the MS anti-cheat lives, and all drivers can only run in a layer between this base layer and userland. I think that's already done for most of the graphics stack.
On the other hand, I am not convinced I want a system where I cannot load arbitrary kernel mode code if I choose to do so.
Can you give examples of games where you do that?
Here's a recent blog post by riot detailing their recent deployment of the system for league of legends, the biggest online multiplayer game in the world
https://www.leagueoflegends.com/en-gb/news/dev/dev-vanguard-...
towards the end it talks about how and why it works