MLB The Show 22

A perfect pitch is broken down by feedback on three criteria:

• Gesture (the path your thumbstick tracks on wind-up)
• Release (how quickly and with the correct timing you get the stick back to the release final circle)
• Direction (how far off left or right you are from the final circle).

Good is the best rating you can get for each individual criteria, then there's Okay, Failed, Early and Late. If all three criteria are Good, then you'll achieve a Perfect for all three.

*I've confirmed this does not work in local multiplayer against a second controller. Unconfirmed if online against a boosting friend will work.
Multiple people confirming this works in Play with a Friend

This achievement relies on some influence RNG, I say influenced because although you can’t actually dictate if the CPU will swing at a pitch or not, there’s things you can do to make it more favourable they won’t. You’re going to be attempting to do this to every single batter you face, throughout playing the game. This is literally your job as a pitcher, to get strikeouts and the ones caught looking are the sweetest of the bunch.

Without delving too deep into pitch strategy there’s some game mechanics and knowledge to consider.

• First turn on Pinpoint pitching from the settings menu if not already on.
• Second turn on API (Adaptive Pitch Intelligence), this will bring up a graphic of the catcher’s suggestion to pitch location, remember this is just a suggestion, but it is based on your pitcher’s pitch portfolio and where the batter’s strengths/weaknesses are in the strike zone, and your previous pitches thrown.
• Third, play on the lowest difficulty setting you’re able to.

You’re going to need to fool the AI into thinking the third strike they’re about to get out on, will be a ball, and thus letting it go by them. You can achieve this by mixing up your pitch velocity and location during the count. If all you pitched was fastballs down the middle, it’s an easy pattern for the batter to recognize and they’ll swing most of the time.

Throw some off the plate, not in the strike zone (but close), throw some off-speed knuckle and curves. Throw up at the top of the zone, and then go low, all keeping the AI guessing what you might do next.

A highly rated pitcher with full energy and confidence meters are going to help. The higher your energy the more accurate your pitches. The higher your confidence the longer your wind up animation time is as well, which helps enable you to perform the controller motion to achieve a perfect pitch.

Offspeed pitches have a lower Gesture accuracy criteria to meet Good/Perfect. Changeups and Sinkers have an even further reduce criteria. If you're struggling to nail perfects, these are good to help achieve them.

Batters lower in the order are typically not as good so you might have better luck down the lineup than the leadoff guys.

This is a matter of time type achievement. It's going to happen as long as you're able to secure strikeouts using Pinpoint, but focusing on things I've said above will help you unlock it sooner than later.

I'm including a video on pinpoint pitching, that explains each step of the pitch and what you need to do. It was created for The Show 21 but the mechanics are still the same. This breaks things down quite well if you're not familiar with the pitching type.

If you prefer a text-guide: In-game you'll pause and got to
Settings> Controls/Guide > Strategy Guide > Pitching > Pg. 2

Check out a Moliitov's suggestion below from the comments:
Please leave a comment and let me know if this helped you or what can be changed to improve for others

Here's an example of me doing it recently in the April Moment's program

Video guide: