How do you handle missing alt text on large WordPress sites?

I’ve audited hundreds of WordPress sites and keep seeing the same issue:

image alt text is missing or low-quality, especially on large sites with thousands of images.

Manual fixes don’t scale, but fully automated tools can sometimes generate poor descriptions.

I’m curious:

• Do you fix alt text manually?

• Ignore it unless there’s an accessibility audit?

• Use plugins or scripts?

Would love to hear how others are handling this in real projects.