There's an entire section in every C/C++ book on pointers which is memory modding.
And C++ won't easily be detected, if you know what you're doing.
In all honesty, every .NET/Cheat Engine app has the same chance of being bannable as they all open ( And keep open btw ) handles to the process while running it.
Since VAC doesn't constantly scan, manually mapping a DLL into a game won't be likely to be detected ( If you're not C&P'ing hack sources ) since mapping a DLL takes place in a fraction of a second ( Aka the handle's closed in that time and VAC only scans every 20-30 seconds or so )
In comparison to other applications:
- Most use static names
- Most keep handles open for long periods of time.