This is me. I blocked so many that nowadays all I get are fake marijuana ads and sex toy ads.
No I don't regularly smoke or otherwise imbibe weed and I definitely don't do stuff that would link me with a need for sex toys lol. And judging by the replies I see to those tweets it's happening to other users too.
Sometimes I wonder if targeted ads are just a giant hoodwinking by big tech over retail businesses. I constantly get youtube ads in languages I don't speak, for tampons or bras (I'm a man), or of musicians in genres I don't listen to. These all seem like extreme table-stakes targeting that can often be inferred from the singular video I'm watching alone, not even including my watch history.
I literally click "allow all" to tracking cookies everywhere. I also get completely inappropriate ads e.g. in languages I don't speak, for services to sell cars (I don't own a car) etc.
They're now making it so you can't block the account that posted the ad, instead you can just say "I don't like this ad" - which still results in the same ad being shown regardless.
I'm still only seeing this on some ads; not sure if it's a gradual rollout or A/B testing. Either way, I'm sure it won't be too long before it's all ads being served like this :(