Threat Actors may establish persistence and/or elevate privileges by executing malicious content triggered by AppInit DLLs loaded into processes. Dynamic-link libraries (DLLs) that are specified in the AppInit_DLLs value in the Registry keys HKEY_LOCAL_MACHINE\Software\Microsoft\Windows NT\CurrentVersion\Windows or HKEY_LOCAL_MACHINE\Software\Wow6432Node\Microsoft\Windows NT\CurrentVersion\Windows are loaded by user32.dll into every process that loads user32.dll. In practice this is nearly every program, since user32.dll is a very common library.
This type of attack technique cannot be easily mitigated with preventive controls since it is based on the abuse of system features.