In true, symmetrically balanced, there is no extra op amp or transformer. But, agreed, that is becoming somewhat rarer, as it is expensive, due to the duplication of circuitry. But, my impression is that use of an op amp or transformer these days imposes negligible performance penalties yet still provides the advantages of noise rejection in balanced transmission.
I seem to recall some better DAC measurements by Amir via balanced outputs. There was lower noise/distortion in some cases, which makes sense because of higher output levels via balanced. But, there may be questions of how audible these improved measurements were. Also, I seem to recall in a few cases, Schiit maybe, better rejection of power supply noise products, possibly due to better grounding via balanced.
My understanding is that RCA engineers wanted the exposed signal lead so they could do circuit continuity tests without other instruments just by hearing the hum in touching the tip to ground. Bad, bad idea.
Agreed, XLR is a great connector.