Being able to list NSFW content is what gives itch.io an edge over Steam, where Steam otherwise utterly dominates almost every indie games marketplace.
Without that, what would set itch apart is DRM-free content, where they have to compete with GOG. All that's left then is a low barrier for entry, which let's be honest, is a benefit offset by tons of spam content.
The itch.io management will have to take great care of a nuanced approach to not have this site be driven into obscurity.
Do they care enough to accomplish this?