If it was powerful enough to warrant use, someone would hack it onto tools.reader. It's obvious where it would go. For some reason, nobody has bothered with this. Likely because the reader already has programmable data (via tagged literals) and anything beyond that results maintaining your own special reader.

I haven't yet encountered somewhere that I'd have used reader macros for that wasn't better solved by using data literals or tagged literals. There might be some random place where I need syntax beyond clojure's data literals, but I'm far more likely to use a combination of data literals + tags. If absolutely required (it hasn't been yet in 5 years of daily production usage), I could simulate custom grammar using clj-antlr and a macro. If, for some unknown reason, I needed a custom non-sexp grammar embedded in my lisp that I wanted to serialize exactly and then read back in the same syntax (probably because I hate myself and/or my team), I could hack it tools.reader.

tldr; you have reader macros if you want them. Nobody wants them who uses Clojure day to day. If they did want them, they could trivially extend tools.reader themselves.