diff --git a/packages/aws-serverless/src/integration/awslambda.ts b/packages/aws-serverless/src/integration/awslambda.ts
index 61776daed18c..2ba148d8b165 100644
--- a/packages/aws-serverless/src/integration/awslambda.ts
+++ b/packages/aws-serverless/src/integration/awslambda.ts
@@ -15,22 +15,19 @@ interface AwsLambdaOptions {
   disableAwsContextPropagation?: boolean;
 }
 
-export const instrumentAwsLambda = generateInstrumentOnce<AwsLambdaOptions>(
+export const instrumentAwsLambda = generateInstrumentOnce(
   'AwsLambda',
-  (_options: AwsLambdaOptions = {}) => {
-    const options = {
+  AwsLambdaInstrumentation,
+  (options: AwsLambdaOptions) => {
+    return {
       disableAwsContextPropagation: true,
-      ..._options,
-    };
-
-    return new AwsLambdaInstrumentation({
       ...options,
       eventContextExtractor,
       requestHook(span) {
         span.setAttribute(SEMANTIC_ATTRIBUTE_SENTRY_ORIGIN, 'auto.otel.aws-lambda');
         span.setAttribute(SEMANTIC_ATTRIBUTE_SENTRY_OP, 'function.aws.lambda');
       },
-    });
+    };
   },
 );
 
diff --git a/packages/node/src/integrations/node-fetch/index.ts b/packages/node/src/integrations/node-fetch/index.ts
index dc0df9b5ef57..cfcc93f1881e 100644
--- a/packages/node/src/integrations/node-fetch/index.ts
+++ b/packages/node/src/integrations/node-fetch/index.ts
@@ -5,7 +5,6 @@ import { SEMANTIC_ATTRIBUTE_SENTRY_ORIGIN, defineIntegration, getClient } from '
 import { generateInstrumentOnce } from '../../otel/instrument';
 import type { NodeClient } from '../../sdk/client';
 import type { NodeClientOptions } from '../../types';
-import type { SentryNodeFetchInstrumentationOptions } from './SentryNodeFetchInstrumentation';
 import { SentryNodeFetchInstrumentation } from './SentryNodeFetchInstrumentation';
 
 const INTEGRATION_NAME = 'NodeFetch';
@@ -33,14 +32,19 @@ interface NodeFetchOptions {
   ignoreOutgoingRequests?: (url: string) => boolean;
 }
 
-const instrumentOtelNodeFetch = generateInstrumentOnce<UndiciInstrumentationConfig>(INTEGRATION_NAME, config => {
-  return new UndiciInstrumentation(config);
-});
+const instrumentOtelNodeFetch = generateInstrumentOnce(
+  INTEGRATION_NAME,
+  UndiciInstrumentation,
+  (options: NodeFetchOptions) => {
+    return getConfigWithDefaults(options);
+  },
+);
 
-const instrumentSentryNodeFetch = generateInstrumentOnce<SentryNodeFetchInstrumentationOptions>(
+const instrumentSentryNodeFetch = generateInstrumentOnce(
   `${INTEGRATION_NAME}.sentry`,
-  config => {
-    return new SentryNodeFetchInstrumentation(config);
+  SentryNodeFetchInstrumentation,
+  (options: NodeFetchOptions) => {
+    return options;
   },
 );
 
@@ -52,8 +56,7 @@ const _nativeNodeFetchIntegration = ((options: NodeFetchOptions = {}) => {
 
       // This is the "regular" OTEL instrumentation that emits spans
       if (instrumentSpans) {
-        const instrumentationConfig = getConfigWithDefaults(options);
-        instrumentOtelNodeFetch(instrumentationConfig);
+        instrumentOtelNodeFetch(options);
       }
 
       // This is the Sentry-specific instrumentation that creates breadcrumbs & propagates traces
diff --git a/packages/node/src/integrations/tracing/graphql.ts b/packages/node/src/integrations/tracing/graphql.ts
index 945327064df2..dbcbe20dcc40 100644
--- a/packages/node/src/integrations/tracing/graphql.ts
+++ b/packages/node/src/integrations/tracing/graphql.ts
@@ -37,12 +37,13 @@ interface GraphqlOptions {
 
 const INTEGRATION_NAME = 'Graphql';
 
-export const instrumentGraphql = generateInstrumentOnce<GraphqlOptions>(
+export const instrumentGraphql = generateInstrumentOnce(
   INTEGRATION_NAME,
-  (_options: GraphqlOptions = {}) => {
+  GraphQLInstrumentation,
+  (_options: GraphqlOptions) => {
     const options = getOptionsWithDefaults(_options);
 
-    return new GraphQLInstrumentation({
+    return {
       ...options,
       responseHook(span) {
         addOriginToSpan(span, 'auto.graphql.otel.graphql');
@@ -73,7 +74,7 @@ export const instrumentGraphql = generateInstrumentOnce<GraphqlOptions>(
           }
         }
       },
-    });
+    };
   },
 );
 
diff --git a/packages/node/src/otel/instrument.ts b/packages/node/src/otel/instrument.ts
index 6f8b10db2ba7..c5e94991140a 100644
--- a/packages/node/src/otel/instrument.ts
+++ b/packages/node/src/otel/instrument.ts
@@ -3,16 +3,47 @@ import { type Instrumentation, registerInstrumentations } from '@opentelemetry/i
 /** Exported only for tests. */
 export const INSTRUMENTED: Record<string, Instrumentation> = {};
 
-/**
- * Instrument an OpenTelemetry instrumentation once.
- * This will skip running instrumentation again if it was already instrumented.
- */
+export function generateInstrumentOnce<
+  Options,
+  // eslint-disable-next-line @typescript-eslint/no-explicit-any
+  InstrumentationClass extends new (...args: any[]) => Instrumentation,
+>(
+  name: string,
+  instrumentationClass: InstrumentationClass,
+  optionsCallback: (options: Options) => ConstructorParameters<InstrumentationClass>[0],
+): ((options: Options) => InstanceType<InstrumentationClass>) & { id: string };
 export function generateInstrumentOnce<
   Options = unknown,
   InstrumentationInstance extends Instrumentation = Instrumentation,
 >(
   name: string,
   creator: (options?: Options) => InstrumentationInstance,
+): ((options?: Options) => InstrumentationInstance) & { id: string };
+/**
+ * Instrument an OpenTelemetry instrumentation once.
+ * This will skip running instrumentation again if it was already instrumented.
+ */
+export function generateInstrumentOnce<Options>(
+  name: string,
+  creatorOrClass: (new (...args: any[]) => Instrumentation) | ((options?: Options) => Instrumentation),
+  optionsCallback?: (options: Options) => unknown,
+): ((options: Options) => Instrumentation) & { id: string } {
+  if (optionsCallback) {
+    return _generateInstrumentOnceWithOptions(
+      name,
+      creatorOrClass as new (...args: unknown[]) => Instrumentation,
+      optionsCallback,
+    );
+  }
+
+  return _generateInstrumentOnce(name, creatorOrClass as (options?: Options) => Instrumentation);
+}
+
+// The plain version without handling of options
+// Should not be used with custom options that are mutated in the creator!
+function _generateInstrumentOnce<Options = unknown, InstrumentationInstance extends Instrumentation = Instrumentation>(
+  name: string,
+  creator: (options?: Options) => InstrumentationInstance,
 ): ((options?: Options) => InstrumentationInstance) & { id: string } {
   return Object.assign(
     (options?: Options) => {
@@ -38,6 +69,40 @@ export function generateInstrumentOnce<
   );
 }
 
+// This version handles options properly
+function _generateInstrumentOnceWithOptions<
+  Options,
+  // eslint-disable-next-line @typescript-eslint/no-explicit-any
+  InstrumentationClass extends new (...args: any[]) => Instrumentation,
+>(
+  name: string,
+  instrumentationClass: InstrumentationClass,
+  optionsCallback: (options: Options) => ConstructorParameters<InstrumentationClass>[0],
+): ((options: Options) => InstanceType<InstrumentationClass>) & { id: string } {
+  return Object.assign(
+    (_options: Options) => {
+      const options = optionsCallback(_options);
+
+      const instrumented = INSTRUMENTED[name] as InstanceType<InstrumentationClass> | undefined;
+      if (instrumented) {
+        // Ensure we update options
+        instrumented.setConfig(options);
+        return instrumented;
+      }
+
+      const instrumentation = new instrumentationClass(options) as InstanceType<InstrumentationClass>;
+      INSTRUMENTED[name] = instrumentation;
+
+      registerInstrumentations({
+        instrumentations: [instrumentation],
+      });
+
+      return instrumentation;
+    },
+    { id: name },
+  );
+}
+
 /**
  * Ensure a given callback is called when the instrumentation is actually wrapping something.
  * This can be used to ensure some logic is only called when the instrumentation is actually active.
diff --git a/packages/remix/src/server/integrations/opentelemetry.ts b/packages/remix/src/server/integrations/opentelemetry.ts
index 7ba99421c82f..dac05ed89d33 100644
--- a/packages/remix/src/server/integrations/opentelemetry.ts
+++ b/packages/remix/src/server/integrations/opentelemetry.ts
@@ -7,22 +7,24 @@ import type { RemixOptions } from '../../utils/remixOptions';
 
 const INTEGRATION_NAME = 'Remix';
 
-const instrumentRemix = generateInstrumentOnce<RemixOptions>(
-  INTEGRATION_NAME,
-  (_options?: RemixOptions) =>
-    new RemixInstrumentation({
-      actionFormDataAttributes: _options?.sendDefaultPii ? _options?.captureActionFormDataKeys : undefined,
-    }),
-);
+interface RemixInstrumentationOptions {
+  actionFormDataAttributes?: Record<string, string | boolean>;
+}
+
+const instrumentRemix = generateInstrumentOnce(INTEGRATION_NAME, (options?: RemixInstrumentationOptions) => {
+  return new RemixInstrumentation(options);
+});
 
 const _remixIntegration = (() => {
   return {
     name: 'Remix',
     setupOnce() {
       const client = getClient();
-      const options = client?.getOptions();
+      const options = client?.getOptions() as RemixOptions | undefined;
 
-      instrumentRemix(options);
+      instrumentRemix({
+        actionFormDataAttributes: options?.sendDefaultPii ? options?.captureActionFormDataKeys : undefined,
+      });
     },
 
     setup(client: Client) {