If you believe a game violates Itch's TOS, you should report it using the button at the bottom of this page.
Asking the community won't help, because the community doesn't make the rules or enforce them.
It could be a mistake, and your report might result in the game or account being deleted. Alternatively, you might believe the game violates Itch's rules, but the staff disagrees, and even if you report it, nothing will be done.
This is the first time I've ever heard of that game. I don't deny that it might be popular within its niche, but it's not a game that everyone knows, so I wouldn't assume the staff is familiar with it.
You can check the exact rules here:
https://itch.io/docs/creators/faq#is-adult-content-allowed
Over the years, what I've seen is that Itch has several rules, but they don't actively enforce them. For example, the rules state that you must have all the necessary copyright permissions for the games you publish, and if you search, you'll see many games based on content from companies like Nintendo, which obviously aren't uploaded by the people who have the copyright permissions.
I'd say the staff trusts that people will follow the rules and tend to act more when someone makes a report than actively searching for those who don't comply with the Terms of Service.
Itch's staff is very small; on the one hand, I doubt they have the human resources to actively enforce the rules, and on the other hand, it also gives developers some freedom, since it wouldn't be pleasant to have the staff reviewing every illustration or line of dialogue in your games.
