Riivolution can load patches from a server (including a computer on the local network running the RiiFS server software), and I think you can change the patches while the game is running, allowing you to modify stuff in real time.
The other option is SNEEK, which I believe has a "cheat menu" that you can trigger in games which allows you to edit memory in real time while the game is running (sort of like what you can do with USB Gecko, only without extra hardware). I am not 100% sure on this, but I remember seeing a YouTube video from crediar about it long ago, so I assume it was actually implemented sometime since then.