For most practical purposes, yes, the DV Lottery is currently the only way most people can get their green card to live and work in the United States.
The two most common alternatives would be to have (1) a close family member who is already a US citizen who can petition for your green card, or (2) an employer who is willing to sponsor you for a green card who can also prove that you would not be taking the job away from a qualified American. Especially in the first case, it can take many years to get authorization for the green card.
If your circumstance does not fall into one of the two categories described above, you would need to be significantly wealthy and be able invest at least $900,000 USD in a business in the United States that employs at least 10 workers, or be a person of extraordinary talent (like a movie star or a sports hero), in order to request and obtain a US green card.
The Green Card Lottery is, for most people wishing to immigrate to the US, the only viable way of seeking a US visa.
You can learn more detail about the available ways to get a green card.