Those Linode instructions are about installing an OS from an installation ISO from Linode's rescue mode. -- I'd consider that more a 'plus' to Linode that you get to be able to install whatever unsupported Linux on Linode's VMs. But, of course it's not as smooth as the officially supported images.
Sibling comment mentions that nix has ways to build NixOS VM images (e.g. https://github.com/nix-community/nixos-generators has a generator specifically for Linode).
Another option is to use nixos-infect, which will replace a Linux distribution with a NixOS distribution. https://github.com/elitak/nixos-infect -- e.g. this blogpost discusses using nixos-infect to deploy NixOS for a cloud provider which doesn't have an official NixOS image. https://xeiaso.net/blog/nix-flakes-terraform
> At that point, I feel like all of the repeatability gains are gone. If I want to spin up a fresh server, I have to read a guide and set stuff up by hand?
Just as with ansible, "git pull to deploy". You'd keep a copy of your NixOS configuration.nix somewhere else, and would be able to apply it later.
> it really does let me just get a new VPS and deploy to it very fast
Using a tool you're familiar with to get the job done is going to be faster than learning to use a tool you're unfamiliar with.
I believe much of the use of NixOS is for hobby stuff, and for personal machines. (c.f. "In what environments do you use Nix", Development (1242) vs Home Server (845) vs Production (386) https://discourse.nixos.org/t/2022-nix-survey-results/18983).