I'd say advanced users or skilled staff.
20+ years ago e.g. Athlon XP had a small CPU die in the middle and 4 round spacers in the corners for a proper heatspreader installation. Despite the CPU die wouldn't clock down and go in flames in case of cooler removal during operation.
Nowadays with a safer CPU monitoring its temperature, one has to risk to remove the heatspreader and replace it with "special" direct die cooling resulting in either a bit more performance or 15-20 grad lower temperatures or a smaller or a silent cooler. One is free to choose.
Sure, even advanced user must take more care working around the naked die. But the technology to make this safer than before could have also matured.