Not really, in theory all you need is that environment flag to set the socket up. I would guess it would work with NPM if it respects it. I ended up with a custom built image originally to fix nameserver detection with named networks in Podman, and then expanded it with some sane defaults.
I do enjoy administering my containers through systemd but it's indeed an inconvenience if you want a more straightforward solution. Arguably using rootless Podman is already a major inconvenience, since you always hit some quirk or need to patch something up because images assume rootful Docker, so I don't mind going an extra mile to have everything set up as quadlets. I do consider using LXC every now and then for certain things just to make it easier in the long run, as matter of fact, I'm still pondering if I shouldn't just create an unprivileged LXC container for the reverse proxy instead of dealing with this (although it has been working mostly great so far).
Other distros have been competing forever. SteamOS is built on top of Arch, which updates multiple times per day. Valve pushes a lot of updates tied to the Steam experience, some of them are also shared with normal Linux desktops, so that makes it somewhat of a moot argument. I run normal Linux (Fedora Workstation) and play games with Steam, and they run the same as my Deck, even day 1 releases.
Like, I get the appeal of a Valve-blessed Linux flavor, but as far as their stack goes, the Linux side of SteamOS is somewhat conservative (not many updates) and limited (due to read-only OS images) compared to normal Linux distros and the gaming side also gets pushed to all Linux distros. As a Steam Deck owner, I personally think Bazzite is more interesting for a real world gaming desktop usage than SteamOS, where you can't even print documents because it lacks the required stack!
To show how conservative it is, I call recall a few examples: