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Highly processed on its own doesn't mean much without taking into account processing method and ingredients used to process them.
These processing methods used may include extrusion, moulding, chemical modifications and hydrogenation (turning liquid unsaturated fats into a more solid form).
In the case of frozen pizzas, the ingredients do not say much, but they are in fact considered a group 3 ultra processed food because of how they were made and the fact that manufacturers don’t need to state the processes foods undergo on the label... just that they are bread, cheese and sauce.
At the same time, we still have quite limited knowledge on what exactly makes ultraprocessed food so harmful. Is it the additives (and which additives exactly), the process (and which process exactly)? Ultraprocessed food is currently treated with a broad stroke, whereas the harm may well come from a very small fraction of additives and/or processes. All of this is very difficult to disentangle because our previous science indicated that the processes/additives now in use were safe.