I've noticed "Projects to rate" no longer lists any nsfw/adult tagged game. This is a reason why you might want to make collections if you don't want to forget about a game.
If you plan on downloading multiple games on itch, I recommend using the itch.io app because it's likely faster than simply using your internet browser. You can still use the itch.io app to download nsfw/adult games even though they're deindexed. If the game's url is still in your browser history, just copy the url from the game page and paste it into the itch.io app.
I 100% blame payment processors (and conservative groups like Collective Shout) for what is happening.
You can call payment processors and complain about the situation on how they're making you not be able to purchase legal games. Here is a list of phone numbers: https://bsky.app/profile/acvalens.net/post/3lux23dwosk2d
If you prefer writing letters, here is a list of payment processors USA addresses: https://bsky.app/profile/sambeawesome.bsky.social/post/3luv2otr3gc26
Calling is preferred over sending emails because it takes up more of the payment processor's employee time. You can call them multiple times on different days to keep up the pressure. If you're calling them again, make sure to tell them that you've called them before. Be respectful to the customer service phone operator, they're not the ones making the rules. If you want to take up more of the company's time, make sure to tell them that you want to speak to their supervisor.