We want to display features based on real world sizes with SimpleMarkerSymbol or PictureMarkerSymbol. But unfortunately there's no way to stretch an Image or SVG path for both width and height. (It's possible with PointSymbol3D but not for 2D symbols).
Codepen (what we're trying to achieve).
You can specify the symbology of each feature to match the approximate size using fields that correlate to each features size. From there, you can resize each symbol (I think you can do this by field(s) but not 100% certain) to be equivalent to the size of the feature.
Here is some documentation that may help.