If it’s really important to you then use Apple / Google / GitHub login.
Obviously this has many downsides, especially from a privacy perspective, but it quickly allows you to stop all but the most sophisticated bots from registering.
Personally I just stick my sites behind Cloudflare until they’re big enough to warrant more effort. It prevents most bots without too much burden on users. Also relatively simple to move away from.
Does that really work? I'm trying to build a site with upvotes--wouldn't it be really easy for someone with 100 bought Google accounts to make 100 accounts on my site?