People tend to assume that all diaphragm regs are sealed and that all piston regs are not sealed. In fact most first stages, piston or diaphragm are unsealed meaning that water is free to enter the ambient chamber.
In the past it was common for piston regs to be codl water protected by having their ambient chambers filled with silicone grease retained by a rubber boot while ambient chambers on diaphragm regs were sealed with alcohol or silicone oil retained with a second thin rubber diaphragm.
Today some piston regs are sealed with an O2 compatible filler in the ambient chamber while a couple designs use a schrader valve and a one way valve to maintain a dry chamber.
Current diaphragm regs are also mostly unsealed with a growing number of designs using diaphragm sealed dry chambers.
In terms of simplicity, unbalanced psiton regs are the hands down winner with one moving part, only 2 dynamic o-rings and no areas inside the reg past the high pressure exposed to high pressure air. They are as simple and as durable as a first stage can get.
Balanced piston regs and most diaphragm regs (all of which are currently balanced) tend to have parts counts and complexity levels that are about equal with a few balanced piston designs perhaps having a slightly lower parts count than the simplest diaphragm designs. op.