It was said that the Holy Roman Empire was neither Holy, nor Roman, nor an Empire. I think that it's about the same when it comes to a lot of fantasy adventure roleplaying games, including D&D, when it comes to its fantasy "medieval European" inspired backdrop. It's mostly these things in name only. It neither feels medieval nor European. It feels modern and American in its thinking, tone, and manner. And many of the appeals I hear GMs make to "medieval Europe" for their world-building or simulationist decision-making logic often goes off gross misunderstandings and misinformation about the European Middle Ages.