RealityKit (iOS & visionOS AR/VR/3D library) makes use of USD. Native apps and games for the Vision Pro will also use USD, alongside their new implementation of Entity Component System (ECS).
Yes, but using .reality files is better for stuff like games in RealityKit. For example it would contain a GPU-ready texture instead of a jpeg (and a lot of other differences), so it's more in-line with how assets are typically loaded in games.