The only way for somebody to DDoS from Cloudflare would be using workers, however, this isn't practical as workers have a very limited IP Range.
I think you're probably right about the spoofing but it comes off a little dismissive when the possibility of a site that queries other sites, could be tricked into doing something it shouldn't, is always going to be in the realm of a possibility.
There was a proposal (BCP38) which said that networks should not allow outbound packets with source IPs which could not originate from that network, but it didn't really get a lot of traction -- mainly due to BGP multihoming, I think.
Some tier-1s do follow BCP38 though, so one day maybe? Still, there's plenty of abuse to be done without spoofing, so while it would be an improvement, it wouldn't usher in an era of no abuse.