I've said this before and I will say it again: "good" social media (if there is such a thing) forces you to use it deliberately; bad social media discourages deliberate use, pushing users to be the 90 in the 90-9-1 distribution. Effort required to use it keeps the signal to noise ratio higher. It's like proof-of-work for humans. the proliferation of many "low quality" relays *should* encourage people to use them more responsibly.
High-quality apps attract low-quality users. Lower quality apps filter those out because it doesn't do or it's outright jank. Users who flippantly scroll-repost-scroll on a loop are like a plague of locusts, creating phantom demand for changes to the service/protocol/software that cater to their consumption preferences, which at best generates friction with higher-quality posters, and at worst drives them away, because the nature of the thing which originally attracted them is either corrupted, or destroyed altogether.
The other problem is that hordes of low-quality users are an untapped market for advertisers. There is little profit motive to advertise to power-users, who are likely taking countermeasures to prevent themselves from being advertised to in the first place.
Spam is less effective when the userbase is savvy and small, conversion-rates are low across the board even for "legitimate" advertising (assuming such a thing exists). Advertising is the great satan that destroyed the web, and any action to prevent any piece of currently ad-free technology from looking like a juicy, untapped market to advertisers is nearly a moral imperative.
The most effective thing to keep advertisers away is to keep the possible number of eyeballs they could reach small and cycnical. The most effective way to do that is low-quality relays, low-quality software, and high quality, specialized content with only niche market appeal.
Nothing less than religious zeal will protect nostr from destruction at the age-old enemy of thought: the advertisment.