The problem with UUIDs that rely on entropy sources is that it is computationally expensive to detect if the statistical distribution of identifiers is diverging from what you would expect from a random oracle. I've written systems that can detect entropy source anomalies but you'll want to turn it off in production.

It is pretty cheap to sanity check most non-probabilistic identifier schemes. UUIDs that use broken hash algorithms (e.g. UUIDv3/5) or leak state (e.g. UUIDv7) are exposed to adversarial exploitation.

The identifier scheme is dependent on the use case. Does the uniqueness constraint apply to the instance of the object or the contents of the object? Is the generation of identifiers federated across untrusted nodes? How large is the potential universe of identifiers?

The basic scheme I've seen is a 128-bit structured value that has no probabilistic component. These identifiers can be encrypted with AES-128 when exported to the public, guaranteeing uniqueness while leaking no internal state. The benefit of this scheme is that it is usually drop-in compatible with standard UUID even though it is technically not a UUID and the internal structure can carry useful metadata about the identifier if you can decrypt it.

Federated generation across untrusted nodes requires a more complex scheme, particularly if the universe of identifiers is extremely large. These intrinsically have a collision risk regardless of how the identifiers are generated.

All of the standardized UUID really weren't designed with the requirements of scalable high-reliability systems in mind. They were optimized for convenience and expedience which is a perfectly reasonable objective. Most people don't need an identifier system engineered for extreme reliability, even though there is relatively little cost to having one.