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Like all the other commenters here, I also devised my own solution—but AFAICT, it's the only other solution that's automated!

Requirements:

  * macOS
  * Zoom
  * Home Assistant
  * A signal light/sign on a smart switch (like [0])

The Procedure:

First, create a script that checks whether you're currently on a Zoom call, and then turns your signal light on or off accordingly. Remember to chmod +x!

  #!/bin/sh

  if [ $(lsof -i 4UDP | grep zoom 2>/dev/null | wc -l) -gt 1 ]; then
    curl \
      -H "Authorization: Bearer ${HOME_ASSISTANT_ACCESS_TOKEN}" \
      -H "Content-Type: application/json" \
      -d '{"entity_id": "${ENTITY_ID}"}' \
      https://${HOME_ASSISTANT_DOMAIN}/api/services/switch/turn_on
  else
    curl \
      -H "Authorization: Bearer ${HOME_ASSISTANT_ACCESS_TOKEN}" \
      -H "Content-Type: application/json" \
      -d '{"entity_id": "${ENTITY_ID}"}' \
      https://${HOME_ASSISTANT_DOMAIN}/api/services/switch/turn_off
  fi

Then, create a LaunchAgent that monitors your Zoom Application Support directory for filesystem changes at ~/Library/LaunchAgents/local.${USER}.on-air.plist:

  <?xml version="1.0" encoding="UTF-8"?>
  <!DOCTYPE plist PUBLIC "-//Apple//DTD PLIST 1.0//EN" "http://www.apple.com/DTDs/PropertyList-1.0.dtd">
  <plist version="1.0">
  <dict>
      <key>Label</key>
      <string>local.${USER}.on-air</string>
      <key>ProgramArguments</key>
      <array>
          <string>${PATH_TO_SCRIPT}</string>
      </array>
      <key>WatchPaths</key>
      <array>
          <string>/Users/${USER}/Library/Application Support/zoom.us/data</string>
      </array>
  </dict>
  </plist>

Finally, load 'er up:

  $ launchctl load ../Library/LaunchAgents/local.${USER}.on-air.plist

[0]: https://www.amazon.com/dp/B09NJ8ZCHF