I don't understand - wouldn't this be observable by the person making the change? They used to call this function / use this class and now they don't any more? Even if it's inside a conditional compilation block.
The hard to detect is the compilers technical reason for not doing the analysis. Maybe it will one day.
In practice, it's annoying to track if those small util functions become dead code.
i did not say "Impossible to detect"!
in practice the exponential explosion of options may become intractable. lets say you have 10 compilation flags with 10 options each. not syre you want the compiler scanning through all that on each pass
That requires a person to be making that change. If the change is vibe coded and the person is only checking that the tests pass, it's not hard for cruft to accumulate.