There are many options; it just takes a bit of creativity, and it's better to involve the designer in the early planning stages to nail down what needs to be immediately accessible, and what can be revealed via progressive disclosure. I did a website for a beverage company a few years back that used a bottom-aligned series of pills for the navigation that scrolled horizontally - a shadow appeared on the side to indicate that it can be scrolled. (We used JS to add shadow to any side which had overflowing elements. See below for a very rough little wireframe.) Twitter, like many sites and apps, also used to have no hamburger menu if you can remember.