Trusted extensions are reviewed by the PostgreSQL community (or vendor) as safe for non-superuser install. They still add capabilities (new types, functions) but are constrained compared to arbitrary C modules.
Untrusted extensions can expose filesystem, network, or arbitrary code execution paths. Treat each as a supply-chain decision.
On managed cloud Postgres, the provider's allowlist is the first gate. Your ADR is the second.
Stack versions: This page was written for PostgreSQL 18.4 (stable 18, maintenance 17), pgvector 0.8+, PostGIS 3.5+, pgbouncer 1.x, and Patroni 3.x.