This is the sad fate of a lot of developers in general, whether in adult games or otherwise. Look at what recently happened with Cyberpunk 2077. Part of the problem was definitely communication, but a huge part of their problem was trying to develop for all platforms all at the same time and time the release together. After release, it was clear they had not done nearly enough work for consoles, at a minimum.
Now translate this to something like adult gaming. If devs would start out with a unique idea and engaging story, even if they don't make things incredibly fancy they could still gain a good following. Look, for instance, at Deliverance or Love of Magic. Both of those are very engaging and heavy on character development and plot. The result can easily be seen: 1Thousand has been on Patreon for just a year and nearly doubled their patron count (from a bit over 90 to nearly 180); Droid Productions has not even been on Patreon a full year and earns nearly $2K per month. When you get enough momentum and support, you can increase quality of your games going forward, a bit at a time, eventually getting to the level of MrDots, Ptolemy, or perhaps even (with enough money for additions to your team) NLT. (Let's not even worry about discussing DarkCookie and Summertime Saga. Lol.)
But there are many factors that play into that as well, like time, patience, ability to overcome obstacles (sickness, financial hardship, etc.), and so on. More than anything, developers need an unquenchable desire to do this permanently going forward; many developers think they have this, but clearly some don't.
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