"Medieval" Fantasy

A group rides down a road.  On either side is farmland, peasants working the fields. There's an inn near the village, and in the distance is a walled city, with a castle in the centre. The group sees wagons with barrels, or hay, there's carriages carrying those of status, and people lug around wheelbarrows, ploughs, and farming tools.

Yep.  That's medieval fantasy.

But where's the fantasy part?

A lot of world building for fantasy games completely ignore the fantasy aspect when it comes to actual civilization. Sure, there's elves, and dwarves, and dragons, and orcs, and wizards and priests. But ... civilization doesn't seem to acknowledge that the very presence of magic and monsters would fundamentally alter how civilization would be changed.

Some anime are taking this into account now -- magic items to mimic things we'd see in the modern day and age (the 'magic microphone to broadcast in arenas' being a good example, flying podiums, teleportation gates, etc), but a number of TTRPGs just don't even think about it. Or they have the excuse of an apocalypse dropping civilization into the dark ages.

But here's the thing.
Magic.

There are spells which increase intelligence to superhuman levels.
There are spells to discern what objects do.
There are spells to discern if you'd screw up on a task you're working on.
There are spells to contact higher, more advanced powers.
There are spells to shape materials into almost anything you want.
There are spells to cause entire fields to grow in an instant.
And so forth and so on.

"This knowledge is lost." There's a handful of spells that says it isn't.
"The scroll crumbles in your hands."  Make Whole exists for a reason.

Consider the knowledge the ancient Greeks and Romans had, and the Middle East in the medieval period. Now, consider what da Vinci would have done with magic to augment his work.

And with Knowledge Skills (Engineering, Arcana, History, The Planes) and Craft Skills, magic and science would work well together.

"But magic stops science".  No, it doesn't. Because not everyone has magic, they'd still have a need to improve on what they've got. You'll have someone or other come up with ideas for progress that didn't have magic. And those who have magic would still come up with ideas, and use magic to make it better.

Sure, someone is going to come up with the excuse that mages want to keep their power and try to suppress technology. Sure. On a global level? And does this actually stop secret societies and criminal organizations and free thinkers?

"The gods stop it."
They're monolithic on this, hmm?  No rival pantheons or gods at odds with one another? No god of civilization who doesn't want to see their people suffering, or a god of medicine, or a god of farming that wants their people to not starve?

The only excuse I can really see for not blending magic into a medieval fantasy is that it requires effort, or that the person setting up the game wants to follow the stereotype. In which case ... one might want to consider nerfing magic to the ground and really cut back on the monsters running roughshod over the region if you want any real suspension of disbelief.

Because all it takes is a single player with any degree of ambition and ingenuity to upend those kind of campaigns (like, say, setting a pit trap involving a portable hole and a bag of holding to swallow a Gargantuan creature that steps on it...)

"But then it isn't medieval fantasy".
There might be a point to that. But that's the question isn't it? How do you keep it medieval while actually accepting magic is transformative?