Often enough, it isn’t an actual ATM. You pay at the counter like you usually would using a card or an NFC payment method (e.g., Apple Pay), but the payment reader processes it as an ATM withdrawal transaction (hence an extra transaction fee of a few dollars). There is no physical cash involved at any point in this (at least not on the dispensary premises).
It feels like it is a state-by-state thing, yeah. I moved from WA to NYC just half a year ago, and I noticed it as well.
In WA, it felt like it was a pretty even 50/50 split (maybe with a heavier lean towards cash) between places accepting cash-only and those that accept debit as well (in addition to cash obviously). I dont remember any that accepted credit cards. All of this is a more recent situation though, as I still remember that just 6-8 years ago, pretty much every single place used to be cash-only. I also noticed some dispensaries experimenting with rather unconvential methods at different points in time too (e.g., Uncle Ike’s using a payment terminal for like a year that worked similarly to a regular debit card one, but it was using crypto as an intermediate medium on the backend to process the payment).
In NYC, it feels like everyone just accepts cards like usual, from grey-market ones to the legal ones.
However, I infinitely prefer the WA situation with cannabis over the NYC one for bajillion other reasons that are entirely unrelated to payment methods.