We're mostly talking about the same thing. Simply put, I'm primarily talking about the distinction between choosing something because it looks cool – and sometimes what looks cool is a very important constraint – vs having intention in one's design choices. Like you point out, things like prominence, progressive disclosure, etc. Those aren't superficial choices; they actually serve a purpose, and are a way to fit within a set of constraints.

For most, yes, it will end up represented in 'how it looks', but I'm underlining the importance of 'how it got there'.

(Aside: worth just highlighting for everyone that not everyone is sighted, that accessibility matters, and that not every design choice is visual.)