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Before 2018, Adobe software utilized a licensing verification system called AMT. PainteR’s patcher worked by emulating this licensing server locally on the user's machine. Essentially, it tricked the software into believing it was constantly connected to a valid Adobe license server. It was "universal" because the underlying AMT architecture was shared across Photoshop, Premiere Pro, After Effects, and Illustrator.
The Reddit threads of 2018 were also filled with cautionary tales. Because these patchers require administrative privileges, they are prime targets for bad actors to bundle with trojans or miners. Universal Adobe Patcher 2018 Reddit