It is indeed! Mostly just fiddling around with the settings.

@smeg@feddit.uk, here is a paste of the config so you can play with it:
(If you click show code editor, then paste in, you can then go back to visual editor with things configured)

Speedtest needle gauges and ping with colour change:

type: horizontal-stack
cards:
  - type: gauge
    min: 0
    severity:
      green: 80
      yellow: 50
      red: 0
    entity: sensor.speedtest_download
    max: 100
    needle: true
  - type: gauge
    min: 0
    max: 20
    entity: sensor.speedtest_upload
    severity:
      green: 16
      yellow: 10
      red: 0
    needle: true
  - type: gauge
    min: 0
    entity: sensor.speedtest_ping
    severity:
      green: 0
      yellow: 15
      red: 20
    max: 100

Air quality with lots of different colours:

type: horizontal-stack
cards:
  - type: gauge
    entity: sensor.oxford_air_quality_index
    needle: false
    min: 0
    max: 500
    segments:
      - from: 0
        color: '#00e400'
      - from: 51
        color: '#ffff00'
      - from: 101
        color: '#ff7e00'
      - from: 151
        color: '#ff0000'
      - from: 201
        color: '#8f3f97'
      - from: 301
        color: '#800000'
    name: 'Air quality: PM2.5'
    unit: µg/m3
  - type: gauge
    entity: sensor.external_environment_f
    max: 40
    severity:
      green: 18
      yellow: 25
      red: 30
    needle: false
    min: -10
  - type: gauge
    entity: sensor.oxford_uv_index
    max: 10
    severity:
      green: 0
      yellow: 3
      red: 6

Once you've got your head around horizontal stacks (lets you put multiple small dials together), it's mostly picking thresholds and settings colours.