Can a plugin cause permanent damage?

Is it possible for a plugin to make permanent changes to a WordPress site? i.e. if I install and activate a plugin, test it out and find it’s no good for me, and deactivate it, is there any way it could leave the WordPress site in a different state than it was before I activated it?

e.g. files in the Media Library altered/added/deleted

e.g. other changes to code or database (outside of the plugin’s own data/code)

In my case, I’m considering installing a plugin that handles lazy loading of images. These work by replacing thumbnail images with a placeholder image and handling loading of actual thumbnails as they become visible on the page. I’m worried that they might permanently replace an image in the media library as part of their setup process and that these would be left broken if I deactivated the plugin. Is that possible? (Especially as every lazy load plugin I’ve looked at has some 1-star reviews saying it doesn’t work in certain situations.)

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