Yeah, at the very least, it would need not an incest patch, but an incest mod adding paths and new artwork by DC. I don't know if he'd be motivated enough, wed enough to the initial concept enough to do that. After all, he's shown no initiative to move over to SubscribeStar.
Well, initially, before the Patreon purge, the people in MC's house were related, as were those next door. If it weren't for the Patreon purge, who knows how many taboo configurations would have shown up. To allow for "wink-wink" totally-not-incest scenes people are asking for, he'd have to convert all the mothers and daughters into landlady and housemates (not-mothers and not-daughters) first. Suddenly none of the young women in town are living with relatives.