Those PCIe power connector temps are wild man.
I have a 5800X3D under a copper AXP-90 and it's also super duper toasty without PBO cranked to -30. the CO -30 setting makes a huge difference for it. I used to have liquid metal under there. It was a bad choice especially due to the pure copper cooler, it wasn't working all that great and then became mildly welded (ended up ripping the CPU out of the socket and had to use a stiff razor blade to detach the heatsink, but luckily no parts were damaged!). Since then running normal paste, the difference between paste and LM is probably less than 5% of the difference that -30 curve optimizer makes, so let me tell ya i was glad they added it to the bios for this CPU.
I want to also note I think I did liquid metal (damn I need to cool it with that stuff) on my NH-D14 on my 5950X, even though this cooler does have the nickel plating it's still pretty fused on there and it's also being awkward to remove. It stopped me actually rearranging my machines the other week, I will just have to remove it after taking the whole motherboard out of the case to do it later.
I think if we add a layer of low profile fans to take up the remaining slot in the U-ITX to force feed it or force pull exhaust, the 5090 won't necessarily be loud especially if we pair it with a tasteful underclock. Ordinarily the extra volume could have been subject to claiming by auxiliary components (fiber NIC in my case). I may still attempt it, but will need to play it by ear.
My 3080ti really struggles on its own inside the velka 7, plenty of airflow obstructions, but a pair of NF-A12x25 bolted on the external side of the side panel to force feed it with fresh air do a phenomenal job keeping it a good 15 degrees cooler than without, so i would comfortably be able to run the GPU with nearly 100W more power with the fans added on. Or equivalently, the noise could be reduced by a noticeable amount.
Obviously if they could have kept a 3 slot cooler on the 5090 it would be more ideal specifically for a case like the U-ITX, but the flow through airflow here should win over any sandwich design case. My understanding is that the U-ITX is strictly only able to host 3.0 slot GPUs so any of these AIB cards are too large, in literally all 3 dimensions.
Actually makes me worry a bit about the 5090's 12V port fitting, but between it being angled already and flexy silicone custom cables, probably will be alright.