I would add a few other things to the list of scaling problems. Some SQL features are hard to scale out (auto_increment/serial columns, unique secondary keys, foreign keys, etc.). Some SQL query operators are hard to scale out for OLTP queries that want low latency and high throughput (DISTINCT, LIMIT/TOP-N, non-collocated joins). I take it SpacetimeDB is a nosql database, so these problems are less important to them?
As to how spacetimedb plans to scale out, I didn't follow it fully. It's hard to take the spacetimedb folks seriously (see: https://strn.cat/posts/spacetime/).