Keysanity add a LOT of time to the run, it would not sit well amongst other runs.

yeaaaaahhhhhhhh.... please?

The leaderboard only covers seeds rolled with vanilla item locations and a couple specialty hacks. These include vanilla preset, which is just the vanilla game created in the randomizer with most of the QOL changes it comes with, inverted vanilla, a festive series that doesn't have any randomization, and a kaizo style romhack.