I don't think a game changes anything.

You can fully reload everything in Clojure as well.

The only limitation is an existing object instance cannot hook into the reload cycle and upgrade itself at runtime. You need to re-create the instance.

But since Clojure is not object oriented, and if you have such objects they'll be from Java interrop, it's not something that you feel you'll be missing or need.

Yes you can hot patch Clojure in production, but modern deployment practices make that not really something people do, as you run multiple instances anyways, it's easier to swap full instances and be sure everything is in-sync with your repo and CI/CD environments.

What people do is more they use a production REPL to help root cause and debug.