Update for anyone interested: Had to remove the Matomo script from my sites before Google would review my Ads. For each Ad account, I have had to ask for a manual review as they kept claiming the Matomo script was still on the website.
In addition, I have two Ad accounts which have been suspended due to Circumventing Systems policy. For these accounts Google has shutdown all communication so I can’t even find out what the specific issue is. Very frustrating. Particularly since it seems its all based on Google’s misinterpretation of the Matomo script.