To me gambling requires betting of long term/valuable resources. In Balatro, the only thing that you'll affect is each individual run, you're back to square one after each as it's a rouguelike. Games like Clash Royale where you can spend actual money on chests for items that affect the game long term, not just for a single match, to me is actual gambling, whereas playing a poker hand using fake chips that only affects that single <1h run absolutely isn't.
It looks like whoever came up with the ratings just saw it uses poker hands for scoring and represents a score with chips, therefore it's gambling, and gave it an 18+ rating, when you're not actually gambling anything (either real world money, or long term items in the game)