Currently, lazier GeoParquet reads, a K-nearest neigbours join, Coordinate Reference System tracking, and built-in GeoPandas IO. These aren't things that DuckDB spatial can't or won't do, but they are things that DuckDB hasn't prioritized over the last year that are essential to a lot of spatial pipelines.
While DuckDB is excellent, I've found the spatial extension still has some rough edges compared to more mature solutions like PostGIS.
1. The latitude/longitude ordering for points differs from PostGIS and most standard geospatial libraries, which creates friction due to muscle memory.
2. Anecdotal: spatial joins haven't matched PostGIS performance for similar operations, though this may vary by use case and data size.
3. The spatial extension has a backlog of long-standing GitHub issues.