Proficiencies are fine, they discourage crafting everything and encourage scavenging for things, thus putting the player in more danger. It's a soft wall. I like them, nobody's forcing you to craft those items instead of going out and looting. And also blacksmithing is hard, who knew. If you still want to sit at home for 2 weeks while you craft everything and power through profs, sure. But you could get all you want faster by, you know, playing the game. Could probably be structured better but the idea of slowing down crafting is fine.
And that discouraging from crafting can be considered a step in the wrong direction.
Obviously, it is unlikelly that the player with his/her NPC allies would be able to restart the chain of mass-production that could be possible in today's world factories, but at least they should be able to satisfy the needs of their community and perhaps a bit more.
Also, sandbox-like games can have certain charms of their own. Slowly rebuilding the world using your own skills (add in building robot companions, if not advanced biological clones, with your own made cloning vats to create NPC copies of yourself). Why this sort of approach is not considered "playing the game"? Why direct violence is the only "meta" approach?
For example the amount of items in houses was drastically buffed long ago because in old Cataclysm they were empty as hell, which basically let the player have tons of canned food. Also like, the only reason they haven't implemented hygiene is that it would add keypresses for no gameplay effect. That's the justification I got from directly talking to them. At least proficiencies, again, give an incentive to not beeline crafting the best things immediately... which I'd argue was detrimental to gameplay, the "cut up some kevlar and then sit at home for 2 weeks crafting survivor armor" routine.
You could already set the amount of items that spawn before in the settings, even if it is a rather inelegant solution (it affects all items, rather than letting the player choose the frequency of certain items spawning).
I expect that if DDA would implement hygiene, it would be similar oddity, like exodites (who change the lore, and basically lock (existing, no less, rather than new and experimental ones) CBMs behind a new, rather undeveloped, faction). It would be like... playing sims at this point - you control the sim when he/she should go to the toilet...
Meanwhile, if BN would try to implement hygiene, I at least expect some interesting crafting ingridients related to fertilizer, mutagens, chemicals, maybe even explosives, should the player gets more advanced tools to purify them.
Last note on proficiencies - seems they are here to counter a 'metagaming' strategy, that was prevalent in earlier versions of DDA. And at this point my question is: Do the devs of DDA have 1 vision regarding how a player should play their game? Or are they pretty lenient on how should one want to play? So far, proficiencies hint at the former, rather than the latter.