The developers of Fedi software have different philosophies. Some developers are just not interested in implementing and supporting all kinds of AP actors, kinds of media, ways of attaching media etc. Because they want their software to focus on a certain thing.
Others want to implement everything and interconnect with every platform.
Interesting! I always thought that once you were a smoker, you have basically cooked your health. Did not know that quitting actually helps with these probabilities.