Doesn't matter if a game uses an unofficial patch, if it's obvious the intent is incest, it gets banned. Games that haven't gotten the boot are getting lucky that no one's reported them. (Unless you're Summertime Saga, then it seems you get special treatment.)
They can, and will ban you for this. As stated above, intent matters. A lot.
Incest is the last thing you should worry about. I think Patreon got all hot and bothered by gnomes here. You see, they're racist, and when they see a gnome they think it's a child, and keep treating it as a child. And they're promoting that racism, forcing us all to think the same or leave.
When they see a flat-chested girl, they start imagining a schoolgirl and how they screw her, how she says all the stuff like "mister it's illegal, mister pwease!". So they prohibit flat chests due to their own sick fantasy being out of control.
Also, when they see a dog, all they can think of is about fucking the said dog. While it's a choice for some people, Patreon can't stand that, and actively search for fuckable dogs in games. They're really agitated about animals...
Now incest though, it's all fine, as long as it's your STEP-mom. Probably because they're foot-fetishists, and at the word step they think of their step-sister stepping all over their chastity-locked micropenis. But when you say "mom", all they can think of is their mom spanking them for saying that she should move out. Not because they wish to live alone, no - it's because when they see their mom, they think about impregnating her and her giving birth to abominations.