According to the article, it is off by default:
According to Google’s updated privacy policy, the company still promises not to use Gmail, Drive, or Google Photos content for targeted advertising by default.
However, the policy now includes an important exception. Google says that restriction no longer necessarily applies “unless you choose to make data from these services available to other Google services that support personalized ads.”
The change is connected to Google’s Personal Intelligence features, which allow services like Search and Gemini to access information from connected apps to provide more relevant recommendations.
For example, someone could give Google access to their Gmail inbox to help organize travel plans or find restaurant recommendations near a hotel reservation.
Under the updated policy, information shared for those personalized experiences could also be used to determine which advertisements appear.
Most likely. Some people in the bottom right have their face on the back of their head. (Also before I noticed that I checked in TinEye, and the earliest occurrence it found was Jan 2025.) And the whole pic has that AI way of smudging together shapes.