Imagine you're playing $1/$3 PLO at your local casino. You have the nut straight on a double suited board in a multiway pot... so you might have QdJd2c2h on a Ts9s8c3c board and it's 5ways. There's $60 in the pot and you have $500 behind effectively. The first player bets $20 and now it's your turn. There are still 3 more players to act behind.

What do you do here? Flat call the $20 or come in for a raise?

And how do you play the river, given that about 90% of the deck is going to kill your hand and you'll have to check/fold the river?
1) If the board pairs you have to worry that someone might have a boat/quads.
2) If a spade comes you have to worry that someone might have a flush.
3) If a club comes you have to worry that someone might have a flush.
4) If a J or Q comes, you have to worry that someone might have a higher straight.

I always get into these kind of spots and I hate it

With all the crazy play that can happen in live PLO games, players are still generally loose/passive. So when flushes and boats hit on the river you can pretty safely fold to aggression. There are spots in PLO where you don't jam a vulnerable nuts hand to avoid being too face up on later streets but this isn't one of them. Its absolutely crucial that you jam this turn for value. Exploit looseness on turn by charging the max, exploit passiveness on river by just folding to bad cards.

fold this hand pre if youre uncomfortable in this spot.

Not raising would likely be a mistake barring some weird dynamic with a player behind you

Look at it this way. You've got 13 outs to the nuts on the river with great SDV if you miss.

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you need to raise to get all the **** draws out. People will rarely call non nut flush draws here to a bet and a raise so you can assume you will be against a set or a NFD. We want to minimise the players that see river.

If someone comes back over the top you may be getting freerolled but you're not folding