Bundlers
Much of the frontend world is setup assuming that you in fact, are using a bundler.
That means that not all stuff on npm, can in fact be easily consumer through ESModules.
Examples;
https://github.com/SAP/ui5-webcomponents/discussions/9487
It is usually possible to work around such limitations, but it is not pain free.
I strongly suspect though that as time marches formward ESModules will become the norm, and this limitation will become irrelevant.
Scale
This project is not backed by anyone making money from it. Support is therefore ad hoc and limited.
In this article