121 countries are unable to make PSN accounts, which means that they are unable to use the PlayStation Store. In a digital-exclusive future—which looks likely for the PS6 after Sony announced plans to cease production of game discs in 2028—that means everyone in those countries will be locked out from purchasing titles on the platform.
Sony is probably like “fucking over those shit hole countries will be worth it for us to fully control the north American, European and Japanese game sales. Fuck em”