I'd say worse than medical. As long as it works and doesn't fail, no one will give a fuck about medical hardware or the condition it's in. Just look at your average GP's ultrasound, it's probably older than the GP themselves is.
Gambling however, you constantly have government auditors and the tax office crawling up your literal arse to make sure you don't cheat the gamblers, or worse, the government out of their money. And in some cases, add the mob or other criminals on top who also want their cut.
Gambling is shady to begin with. It’s easy to say that all businesses only care about money, but gambling is pure greed, from both the customer’s and proprietor’s perspectives. Sure, there is greed in medical but gambling is ONLY greed.
There are seals on the hardware, any modification must be approved, you must certify that the payout is the expected one, ...