I think they mean vastly reduced in size and scope by DOGE, since Mr Musk is apparently doing all of his government work in a state of ketamine induced mania.
Musk takes so much ketamine that his mental abilities are clearly impaired, let alone his physical health(long term k use has a bunch of serious health issues).
Elon's ketamine abuse is well documented. He's also boasted about taking it.
It’s a play on the rumours that Musk abuses his ketamine prescription. Note that I’m not advocating for the rumours. Merely explaining.