I've played more than one game (Freespace, Tribes, Warframe) that had more than 30 keybinds. Managing keymaps can be challenging, but it's not impossible.

And discussing this reminds me how much of a pain it is. What we need is a system where we set our own defaults in an XML file or some other common format (or use a software tool to do that). Then we can select this keymap when we install applications.