Assuming that $A(t)$ is analytic at $t=0$, getting a power series solution $M(t)$ at $t=0$ of $M'(t) = A(t)M(t)$ is trivial, of course. You just write $A(t) = A_0 + A_1 t + \cdots$ and $M(t) = I_n + M_1 t + \cdots $ and then recursively solve, for $k>0$
$$
k\ M_k = A_{k-1} + A_{k-2}M_1 + \cdots + A_0 M_{k-1}\ ,
$$
so $M_1 = A_0$, $M_2 = \tfrac12(A_1+A_0^2)$, $M_3 = \tfrac16(2A_2 + 2A_1A_0 + A_0A_1+A_0^3)$, etc. If $A(t)$ is sparse, then computing the various products of the $A_i$ might not be hard; it depends on the matrix.
One case in which one can integrate the fundamental equation by elementary means is when $A$ takes values in a solvable Lie subalgebra $\frak{s}$ of $\frak{gl}(n,\mathbb{R})$. In this case, by a theorem of Lie and Engel, $M(t)$ can be computed from $A(t)$ by a sequence of quadratures. (The abelian case is, of course, the simplest case of this.)
Meanwhile, it is a classical theorem that, when $n\ge 2$, there is no sequence of algebraic operations and quadratures that will produce $M(t)$ starting from the general $A(t)$.
More generally, if you add to your allowable operations, an 'integration procedure' $IP_{\frak{g}}$ for each simple Lie algebra $\frak{g}$ that will solve the equation $M'(t) = M(t)A(t)$ for any curve $A:\mathbb{R}\to\frak{g}$ for the corresponding $M:\mathbb{R}\to G$, then the equation $M'(t) = M(t)A(t)$ can be solved for any $A$ taking values in any Lie algebra $\frak{a}$ by a sequence of applications of the $IP_{\frak{g}}$ for the simple $\frak{g}$ that appear in the Levi decomposition of $\frak{a}$, followed by a sequence of quadratures.
Look in any good book on differential algebra for a discussion of this, as well as the independence of the operations $IP_{\frak{g}}$ for different simple Lie algebras. The case ${\frak{g}} = {\frak{sl}}(2,\mathbb{R})$ is, of course, the theory of the Riccati equation.
By the way, this result about solvability was one of the primary motivations for wanting to classify the simple Lie algebras. In fact, all of the classical techniques (such as variation of parameters, getting the general solution of the Riccati equation by quadrature from a single solution, etc.), are special cases of general techniques for reducing or solving equations by the use of group actions, and this was the original motivation for studying Lie group actions and homogeneous spaces of Lie groups.