There are only two possibilities - either it's what people actually want, at which point the whole half-a-trillion-dolar marketing industry is a huge waste of time, or marketing actually works and people want different things than they'd want if not influenced by it.
I don't think it's "paternalistic" to recognize the power imbalance present here. I think it's stupid not to.
Imagine there is a human desire X in some people, and there are three products A, B and C designed to fulfill that desire. Do you honestly think the marketing industry is stupid enough to primarily be engaged in trying to sell product B to people who DON'T have desire X? Of course not. The idea is to convince people that product B does a better job of fulfilling desire X than competing products A and C. Or at least that it optimises some other variable – it might not be universally better, but it may be a whole lot cheaper, or easier to get a hold of, or have better customer support.
Real[1] marketing is mostly concerned with finding the people who have a particular need, and making sure they are aware of a product that fulfills that need, and what the strengths of that product are.
Marketing is fundamentally about increasing sales as much as possible with as little expenses as possible. The most efficient way to do this is to find people who already would have wanted your product if only they were aware that it exists, and make them aware that it exists. Convincing people to buy things that fulfills needs they never had is possible, but takes a lot of effort. Too much to be worth it, in most cases.[2]
----
[1] This may sound like I'm moving the goalposts, but all I'm really trying to do is guard myself against the obvious "but I got this viagra marketing spam email which does not fit your description" rebuttal.
[2] Yes, there are plenty of "artificial needs" to go around, but most of them are created by culture, of which only a smaller part is marketing. They're rarely created by a single, hugely effective marketing campaign. (I say rarely, because De Beers comes to mind...)
[1] no true scotsman is exactly what you are doing.
[2] it's nonsense to say "artificial needs are created by culture, of which only a smaller part is marketing," when marketing, consumerism, and commercialism are so thoroughly pervasive in our culture. Hell, even religious holy days have become utterly commercialized. Industrialized people are inundated with advertising.
I think you're absolutely right about "real" marketing, but I think you're giving it too much credit. "unreal" marketing is much more real.
I don't think it's "paternalistic" to recognize the power imbalance present here. I think it's stupid not to.