I guess I should consider myself very fortunate. It works out very well for me. I've worked under an unlimited PTO policy for several years now (at two different companies).

It does not "depend on management approval." Approval for time off is automatic; it is only necessary to coordinate with your supervisor and/or team to make sure tasks can be handled by coworkers in your absence. Vacations were typically one to three weeks, sometimes longer for international travel or special situations.

There is no "pressure to keep the PTO profile low" or limit the amount of time. It isn't even tracked.

It's not a "loss of a benefit." I've been able to use more time off than before, even with the most generous PTO benefits at prior organizations.