I suspect that decades of C being effectively frozen have caused the userbase to self-select to people who like C exactly the way it is (was), and don't mind supporting ancient junk compilers.
Everyone who lost patience, or wanted a 21st century language, has left for C++/Rust/Zig or something else.
In my experience, Windows devs don't like being told to use a different toolchain. They may have projects tied to Visual Studio, dependencies that are MSVC-only or code written for quirks of MSVC's libc/CRT, or want unique MSVC build features.
I found it hard to convince people that C isn't just C (probably because C89 has been around forever, and many serious projects still target it). I look like an asshole when I demand them to switch to whole another toolchain, instead of me adding a few #ifdefs and macro hacks for some rare nice thing in C.
Honestly, paradoxically it's been easier to tell people to build Rust code instead (it has MSVC-compatible output with almost zero setup needed).