The dynarec systems in QEMU aren't as efficient as the native dynarec systems in Windows and macOS (Rosetta 2). You can definitely run x86 Windows with UTM, and it works, but the performance characteristics are pretty poor. From a utility perspective, I've found that running an ARM Windows VM and using Windows' dynarec system to run x86 apps, or using WINE (both using native compiled subsystem code) is a much better experience. It's one of those things where it's okay if you need to run a workload in a pinch.

I'm not sure if performance characteristics are part of what the OP considers "sane", but if it is, I get the position.