With self hosted email and at least Proton Mail (and probably other paid solutions), you can set up a "catch all" address. With that, any non existing email gets redirected to one; for me, I have spam@domain.com so, while myname@domain.com goes to my inbox, thisaddressisinvalid@domain.com and, I don't know, walmart@domain.com both go to spam@domain.com. I don't need an individual entry for every alias and I can specifically block any address that's particularly spammy or compromised.
I hear that you can have a similar setup with something called SimpleLogin, but I've never tried that.