Yup.

I always look at the ride analysis - most of the time, it's pretty clear that it was unintentional. On the speed chart, you'll usually them noodling along at 12-15mph for a while. Then there's a transition (looking at the Time graph, rather than the default Distance, is helpful in seeing transitions/breaks in the action) and then they're accelerating like monsters and have cruising speeds of 30+ mph. Yup - they forgot to stop recording their activity when they got back to their car.

Another red flag that I'll look for is the roads traversed - jumping on a highway is obviously not normal bike activity. Also, in my area, it's unusual for a cyclist, no matter how serious, to completely avoid bike paths and shortcuts.

E-bikes can be tougher to spot, but they do often have distinctive, lurching speed graphs; I assume that this is from bumping in to the limiter.

Last year, we had a guy in our area that kept intentionally recording rides in his car, scooping up tons of KOMs. He'd get flagged immediately by dethroned and used to his routine, but man, was it annoying, and Strava wouldn't do anything about him, other than let users police him. Odd.