I realize this isn't what you meant by "lower level" but nevertheless viewing the Cell Expression for various kinds of output can be interesting and informative. Based on observing that expression it is possible to craft this:
DynamicBox[
Manipulate`ManipulateBoxes[1, StandardForm,
"Variables" :> {a$$ = 0},
"ControllerVariables" :> {Hold[a$$, 0]},
"OtherVariables" :> {},
"Body" :> Plot[Sin[x (1 + a$$ x)], {x, 0, 6}],
"Specifications" :> {{a$$, 0, 2}},
"Options" :> {},
"DefaultOptions" :> {}
]
] // ToExpression

Of course direct use like this isn't advisable because I have stripped out all localization etc. for this example that is normally generated automatically.
As a further point of curiosity, if you want to see the very low level Box expressions, leave off DynamicBox
and ToExpression
from the example above to reveal this:
PaneBox[PanelBox[
DynamicWrapperBox[
GridBox[{{ItemBox[
ItemBox[StyleBox[
GridBox[{{TagBox["a", HoldForm],
TagBox[PaneBox[
DynamicModuleBox[{Typeset`open$$ = False,
Typeset`paused$$ = 0, Typeset`rate$$ = Automatic,
Typeset`dir$$ = Forward},
StyleBox[
DynamicBox[
FEPrivate`FrontEndResource["FEExpressions",
"Manipulator04"][Dynamic[a$$],
Dynamic[a$$], {0, 2}, Medium, Small, Automatic,
True, Automatic, False, True, True, All, False, {},
Dynamic[Typeset`open$$], Dynamic[Typeset`paused$$],
Dynamic[Typeset`rate$$], Dynamic[Typeset`dir$$]]],
DynamicUpdating -> True],
DynamicModuleValues -> Automatic], ImageMargins -> 0,
BaselinePosition -> Baseline],
Manipulate`InterpretManipulator[
Dynamic[a$$], {0, 2}, {ContinuousAction -> True,
AutoAction -> False}]]}}, AutoDelete -> False,
GridBoxItemSize -> {"Columns" -> {{Automatic}},
"Rows" -> {{Automatic}}},
ColumnAlignments -> {Right, Left}], "ManipulateLabel",
StripOnInput -> False], Alignment -> {Automatic, Inherited},
StripOnInput -> False], Background -> None,
StripOnInput -> False]}, {ItemBox[
TagBox[StyleBox[PaneBox[DynamicBox[ToBoxes[Refresh[\!\(\*
TagBox[
RowBox[{"Plot", "[",
RowBox[{
RowBox[{"Sin", "[",
RowBox[{"x", " ",
RowBox[{"(",
RowBox[{"1", "+",
RowBox[{"a$$", " ", "x"}]}], ")"}]}], "]"}], ",",
RowBox[{"{",
RowBox[{"x", ",", "0", ",", "6"}], "}"}]}], "]"}],
Identity,
Editable->True,
Selectable->True]\), TrackedSymbols -> Full], StandardForm],
SynchronousUpdating -> Automatic], ImageMargins -> 10],
Deployed -> False, ScriptLevel -> 0,
GraphicsBoxOptions -> {PreserveImageOptions -> True},
Graphics3DBoxOptions -> {PreserveImageOptions -> True},
StripOnInput -> False], Identity, Selectable -> False,
Editable -> False], Alignment -> {Left, Center},
Background -> GrayLevel[1], Frame -> 1,
FrameStyle -> GrayLevel[0, 0.2], ItemSize -> Automatic,
StripOnInput -> False]}}, AutoDelete -> False,
GridBoxItemSize -> {"Columns" -> {{Automatic}},
"Rows" -> {{Automatic}}}, ColumnAlignments -> Left,
GridFrame -> False, GridFrameMargins -> 1, RowSpacings -> 2,
RowAlignments -> Top],
If[CurrentValue["SelectionOver"],
Manipulate`Dump`ReadControllerState[(Manipulate`Dump`updateOneVar[\
#1, CurrentValue["PreviousFormatTime"],
CurrentValue[
"CurrentFormatTime"]] &) /@ {Manipulate`Dump`controllerLink[
a$$, "X1", If["DefaultAbsolute", True, "JB1"], False, {0, 2},
1.]}, CurrentValue[{"ControllerData", {"Gamepad", "Joystick",
"Multi-Axis Controller"}}], {}]]], DefaultBaseStyle -> {},
FrameMargins -> {{5, 5}, {5, 5}}], ImageMargins -> 0,
BaselinePosition -> Automatic]
I am rather glad we don't have to do "low level" FrontEnd programming very often!