Alt (assuming you actually mean Meta ;) is completely unnecessary for emacs. Meta-<Key> can always be produced by pressing ESC <Key>
I guess technically ctrl is also unnecessary since you could type out whole commands with M-x (ESC x command). It wouldn't be fun, but you could do it.
Although most keyboards nowadays use Alt for Meta, they were distinct keys on some older keyboards. I personally never used an MIT Lisp machine, but I have used Sun keyboards with a Meta key.
It's also fun to note that EMACS is an acronym for Escape Meta Alt Control Shift, which generally describes the experience of using it.
As joke acronyms go, I preferred "Eight Megs And Constantly Swapping" back when Eight Megs was a lot of memory. "Eighty Megs" worked for a while after that. These days you'd have to rename it EGACS to use that joke.
For what it is worth I use an "otaku" Happy Hacking KeyBoard Pro 2 (HHKB Pro 2) with "blank" black keys and I remapped | to HYPER+[ (and I'm of course using right alt as a "new" modifier, HYPER).
tl;dr: you can't never be sure how Emacs hacker have configured their keys/modifiers ; )
edit: For that matter, how did he type "ps -ef | grep -i os12" with no "|" key?