As others mentioned, IDE can be achieved with a converter. I personally use an IDE to SATA converter to connect an IDE DVD drive with analog audio for DOS games. The BIOS has legacy IDE mode or the default AHCI.
The floppy connector is the real challenge IMO. Doubly-so if dual drive support is required.
The last build in my signature (HP Z400) is my daily Win11 workstation, and it happens also to be my fastest native DOS machine. My main line of work is 3D game programming, so lots of C++ compilation (hex-core 12-thread CPU, M.2 SSD) and heavy reliance on a decent 3D card for ray-tracing (RTX 2080Ti).
Of course it's not a thread-ripper, so not suitable for Unreal, but I don't use commercial engines.
To go DOS native, I just switch BIOS to IDE mode, and put a USB stick formatted to DOS 6.22. The BIOS boots from the USB as C drive, and I get access to A (floppy disk) and D (CD drive) with full sound blaster support and original OPL3.
The only caveat is no dual floppy drive. Even though I have both drives installed (5.25 and 3.5), I only can connect one at a time.. so I tend to batch my floppy disk work as 3.5" disk batches and 5.25" disk batches.
In DOS native mode, compatibility is really high. Doom and Duke3D are butter smooth. And SetMul L1D will bring down speed to 386 levels.. so some speed-sensitive games can also work.
I also have SATA drives that are disabled in BIOS by default, but if enabled, one has Win98 SE on it, and the other has WinXP. Both also work great but I rarely use them honestly.
Turbo XT 12MHz, 8-bit VGA, Dual 360K drives
Intel 386 DX-33, Speedstar 24X, SB 1.5, 1x CD
Intel 486 DX2-66, CL5428 VLB, SBPro 2, 2x CD
Intel Pentium 90, Matrox Millenium 2, SB16, 4x CD
HP Z400, Xeon 3.46GHz, YMF-744, Voodoo3, RTX2080Ti