attr_accessor, as it happens (http://ruby-doc.org/core-2.0.0/Module.html#method-i-attr_acc...) is implemented in C code, but one could implement it in Ruby, so I'd count it as part of the (standard) library, and creating accessors is just using a library method. In, say, Java setters and getters have to be written by hand (or autogenerated by some external system like an IDE), so they're a pattern. On the other hand, the way Ruby translates `foo.bar = 3` into a call to `foo`'s `bar=` method is not alterable by user code, so it's part of the language.
MVC in Rails is an interesting case. You have to create new classes according to the pattern (either by hand or using `rails generate`), but there's also some library support in the form of Model and Controller classes you're expected to inherit from, and which handle much of the View/Controller plumbing for you. I'd say it's still a pattern, though.