In the last few months, I've used 30-bit color on Gentoo in the context of microscopy and data visualization.
Enabling it with a modern NVidia card is dead easy. Basically, in xorg.conf, replace occurrences of 24 with 30. However, not much makes use of the extra colors. Although Qt5 will correctly output 24-bit color in 30-bit mode, Krita is the only Linux application of any kind I found that can actually display additional colors. It's easy to test - show a full screen gradient.
No OpenGL compositors (eg kwin, compiz) support 30-bit color to any extent. Total fail, here. Tearing like it's 1998.
Notably, with Qt5, it does work to make 10-10-10-2 and 10-10-10-0 GL contexts and render to them with your own old-school GL calls, nv_path_drawing, and compat & core profile shaders. However, you do have to manage the GL context yourself - QOpenGLWidget has no 10-bit suppport. You can still use Qt's GL abstractions, just not QOpenGLWidget. Easiest approach is to use QWindow in a widget container (created with that QWidget.createContainersomethingorother static member function), as was commonly done with Qt 5.3 (ie, before QOpenGLWidget).