The proper approach to resolving this in an elegant way is to make the guarantee target-dependent. Require all depended-upon crates to acknowledge that usize might differ from uptr in order to unlock building for "exotic" architectures, much like how no-std works today. That way "nearly every platform" can still rely on the guarantee with no rise in complexity.
Yet Rust is not Go and this solution is probably not the right one for Rust. As laid out in a link on a sibling comment, one possibility is to do away with pointer <=> integer conversions entirely, and use methods on pointers to access and mutate their addresses (which may be the only thing they represent on some platforms, but is just a part of their representation on others). The broader issue is really about evolving the language and ecosystem away from the mentality that "pointers are just integers with fancy sigil names".
Pointers should at no point be converted into numbers and back as that trips up many assumptions (special runtimes, static/dynamic analysis tools, compiler optimizations).
Additionally, I would make it a priority that writing FFIs should be as easy as possible, and requires as little human deliberation as possible. Even if Rust is safe, its safety can only be assumed as long as the underlying external code upholds the invariants.
Which is a huge risk factor for Rust, especially in today's context of the Linux kernel. If I have an object created/handled by external native code, how do I make sure that it respects Rust's lifetime/aliasing rules?
What's the exact list of rules my C code must conform to?
Are there any static analysis/fuzzing tools that can verify that my code is indeed compliant?
So as to not only hate on Rust, I want to remark, that baking in the idea that pointers can be used for arithmetic isn't a good one as well.
Can you expand on this point? Like are you worried about whether the external code is going to free the memory out from under you? That is part of a guarantee, the compiler cannot guarantee what happens at runtime no matter what the author of a language wants, the CPU will do what it's told, it couldn't care about Rusts guarantees even if you built your code entirely with rust.
When you are interacting with the real world and real things you need to work with different assumptions, if you don't trust that the data will remain unmodified then copy it.
No matter how many abstractions you put on top of it there is still lighting in a rock messing with 1s and 0s.
Rust worded in its initial guarantee that usize was sufficient to roundtrip a pointer (making it effectively uptr), and there remains concern among several of the maintainers about breaking that guarantee, despite the fact that people on the only target that would be affected basically saying they'd rather see that guarantee broken. Sort of the more fundamental problem is that many crates are perfectly happy opting out of compiling for weirder platform--I've designed some stuff that relies on 64-bit system properties, and I'd rather like to have the ability to say "no compile for you on platform where usize-is-not-u64" and get impl From<usize> for u64 and impl From<u64> for usize. If you've got something like that, it also provides a neat way to say "I don't want to opt out of [or into] compiling for usize≠uptr" and keeping backwards compatibility.
If you want to see some long, gory debates on the topic, https://internals.rust-lang.org/t/pre-rfc-usize-is-not-size-... is a good starting point.