If you modify a base package, like maybe to apply some minor patch on a systemd executable as an example, is there a way to avoid having to recompile basically all installed packages (for being at least indirect dependents)? Had a problem like that about a decade back.
No, it doesn't recompile everything, that's not how Nix works. The only way it would recompile everything is if, for example, you modified a particular version of glibc that was imported by most packages. Something else must have happened. I modify udev rules and the system rebuilds in seconds.
That's the great thing about nix, it should actually compile LESS than other distros, because, you can have multiple versions of the same lib on the same machine. You just create another version of the package and only patch the packages that need it. You don't even have this option on other distros. Name one other distro that lets you run multiple versions of glibc natively (not containers or flatpaks or whatever).