It would be most likely in these given situations that the customer would have their own I/O breakout and transport options, and would be looking merely for the backstop end of the chain to be rock solid, stable, reliable and well clocked.
RME have that side of the market sown up and have done for the best part of 8 years. In particular they were the first to market with OEM PCI MADI cards, at a time when only Euphonix, Fairlight and to a lesser extent Lawo and Harrison were offering such things, and all three of the latter only as part of on- or off-line DSP packages, not for individual I/O use.
In this day an age of expanded comupting rigs, particularly with the adoption of slave machines for outboard DSP processing or sample generation and playback, both the high I/O MADI cards and the lower I/O 9652s and the like have their place. Again, RME were quickest off the bat with PCI-X and again with PCIe, which has kept the pro market very happy indeed.
As for the options cards, they're there for situations where the customer would like to tailor a specific machine quickly and easily if for example they need a quick 6 or 8 out of an OB rig for surround monitoring offline or backup, and the clocking cards for those that are using poorly clocked sources and need reference to an OB, House or Vid clock hard wired and cannot simply resort to RME's own SyncAlign.
For my part I've been using RME gear for seven years now, and I am still running two of the cards I bought right back on day one - still being updated in firmware and drivers, still operating without fault.
You get what you pay for.... and if you don't need their features, then don't buy them.
Ars longa, vita brevis, occasio praeceps, experimentum periculosum, iudicium difficile.