When you're doing gamedev & are bumping up against your FPS, the GC is just another form of memory management. Doing GC-per-frame tends to work pretty well with a generational GC (generational hypothesis & frame-by-frame updates go hand-in-hand), but you usually have to take care about long-lived data. That's when you end up getting into more manual memory management combined with a GC. In a way, your GC'd high-level language RTS ends up being your scripting language.

That's how I've been thinking about it with Haskell at least (lots of GC knobs, manual performGC hook, compact regions for having long-lived data, good FFI, as high-level as any scripting language you could hope for)