There are plenty of high schools that offer very limited AP courses, don’t have IB at all, AICE isn’t there, and neither is the opportunity to take courses at some four year college DE.
We live in a pretty wealthy state. Our high school has about 10 AP courses, but the school is small, and many of these courses are offered at the same time as others. Students simply can’t take them all. We don’t have any of the other things above. Kids can take DE courses through a local community college.
We have had students accepted at all of the Ivies, and a number of other elite schools (Stanford, MIT, etc).
These were very strong students with outstanding SAT scores and nearly perfect or perfect GPAs…and significant ECs with strong commitment.
No national awards…those things just aren’t a thing where we live.