Look at the insane expression of the guy behind trump.
Look at the head that is either coming out of trump's head, or he's standing impossibility close to trump.
The lighting and colors make it look like those AI generated videos like "AI dark fantasy movie from the 80s"
Though some details like the dirty fingernails on the leftmost guy makes me doubt.
The Guardian has it on their site, top billing - so either it is entirely real or it's fakery and the Graun picture editor is going to get their ass broken into bite-size chunks.
But it is real - there's a video taken from the same position with the same people.