I believe the US iPhone 15 models all only use an eSIM, not a physical SIM card. You would have to find a carrier in Pakistan that does those.
About region blocks, I have not heard of those. It isn't something Apple does, except possibly if you are trying to use an account set to the USA and are trying to get items from the USA store while in other countries. That has nothing to do with cell service.
If you have problems with the phone, Apple will not repair it except in the USA. Warranty restriction! - Legal - iOS Warranty Document Us - Apple - "IMPORTANT RESTRICTION FOR iPHONE, iPAD AND APPLE TV SERVICE. Apple may restrict warranty service for iPhone, iPad and Apple TV to the country where Apple or its Authorized Distributors originally sold the device."
The warranty does not outright deny warranty coverage in other countries but there are many limitations to the effect Apple almost certainly will refuse to do repairs under warranty or even repairs at all except in the country of purchase. The device would have to be sent to a friend in the country of purchase to handle any repair claims because Apple will not handle international shipping.
Don't forget that USA prices on the web site do not reflect sales tax.
Also do not forget that many countries may impose hefty customs and duty on some items. You may still end up paying more in the end, plus you have all the disadvantages of having a phone from another country.