There was a tweet going around a while ago that I'll try to re-state. Adwaita is not really a "theme" it's more like a CSS framework that you build your app on top of. Trying to swap out the theme is like trying to take a site built for Bootstrap and putting the CSS from Foundation on top of it, you might be able to hack it to sort of get it to work but what you're doing is combining two things which are fundamentally not compatible. Hopefully that helps explain why the method that people were using for third party theming in GTK3 was unreliable.
In GTK4, the Adwaita theme has actually been removed from GTK and moved into libadwaita. That could mean some changes for some things, but not other things. Will all GTK3 apps port to GTK4 and libadwaita? Probably the GNOME ones will, but other apps might not. In that case it would be up to those developers to come up with a solution for theming, they could try to base that on CSS, or they could do something else.