"While Exchange 2016 offers a wide variety of architectural choices for on-premises deployments, the architecture discussed below is our most scrutinized one ever. While there are other supported deployment architectures, they are not recommended."
While the PA definitely adds value, it's important to realize that this architecture does not make sense for every organization. Most visible is of course the assumption that the customer has a requirement for site resilience, which many small and medium organizations
typically not have.
Even though the PA has it's limitations in practice, I highly recommend Exchange consultants or architects to use the PA as a guideline for their design. If an organization is not able to follow every single aspect of the PA, and I have met very few who adapt
to PA for the full 100%, they should at least document why they deviate from the PA for those aspects.