Many other distros almost work out of the box (as in they boot and run without any modifications). The custom kernel patches you mentioned address mainly non-critical bugs such as a bug where the Realtek r8127 stops working after a reboot (but it works if you turn it off and on again) [1] [2]. I'd consider it in a way better state than trying to run other Linux distros on certain device tree-based devices like, say, Qualcomm Snapdragon machines. The regular NVIDIA drivers with the open source kernel modules work just fine. Talos Linux supports DGX Spark since version 1.12 [3]. I also know of people using Fedora and nixOS successfully.
iirc the bug that the R8127 patch was addressing was fixed in the R8169 driver upstream in kernel 6.18 and later. Not super sure what other patches there are and what the status of those are...