It is for sure a valid security concern when doing client-side XSS filtering, which is what the presentation is about. And no, DOM Clobbering does not require an attacker to "have access to the page in your user's security context". Fastmail have an introduction here: https://fastmail.blog/2015/12/20/sanitising-html-the-dom-clo.... Simply put, there's no way to do safe client-side XSS filtering without addressing DOM Clobbering as a valid security concern.
"hardening the DOM won't provide the necessary solution."
And the author is not suggesting or waiting for that. On the contrary, the premise is that XSS sanitizers need to be client-side exactly because the DOM is not hardened and has so many different implementations (even across browser versions). It's counter-intuitive I know, but server-side XSS sanitizers really can't address cross-browser parser differences safely. So again, it's not a question of "stylistic concerns" or "code management" but of doing secure XSS filtering wherever it is best done.
"There are better ways to solve for this."
And if you go on to the next slide, 28, the point is that despite the difficulties, this has been solved in DOMPurify, which should be added to the DOM so that developers can finally have a first-class client-side XSS sanitizer, without having to trust DOMPurify as third-party code.
There are not many people who know more about client-side XSS filtering than Mario Heiderich. And I know of no better client-side solution than DOMPurify.