Misanthrope Prime
Adventurer
The presence of things like disability representation or defiance of beauty standards come, to a degree, from the desire for a work to be "realistic." There are disabled people or people with skin conditions in reality, therefore, it follows that they should appear with at least the same frequency they do in the general population now, in 2023, as they do in fiction.
Of course, this verisimilitude is at the opposite end of "fantasy." If D&D were a game in a different literary genre (to say nothing of its gameplay) you might have a point, but this genre is defined particularly by how it differs from reality. 5e D&D and its flagship products are also squarely in the "high fantasy" subgenre of fantasy; a dark fantasy or horror influenced fantasy would of course take inspiration from how reality is uncomfortable and amp it up, but instead high fantasy tends to want to portray an idealized world; one where concerns like physical attractiveness and even general health and disability are not a consideration. Remember; all art is propaganda, and high fantasy borrows heavily from mythology: mythology has an incentive to portray its protagonists as physically perfect ideals of what to strive for, rather than reminders of how reality current sucks.
D&D does have some non-high fantasy sub IPs, and I'd argue that in art for those you do tend to see a lot fewer attractive characters. Greyhawk has barely been in 5e but GoS has some pretty gross looking townsfolk, and while she's gorgeous they did make a big deal about D&D's first autistic character being from Greyhawk- so that's another point for diversity there. I can probably find plenty of portly and pockmarked characters in Ravenloft art if I go looking, and Dark Sun is known for making everyone and everything hideous. Most of 5e's art is either set in the Forgotten Realms or "Planar" settings which also tend to be very high fantasy in aesthetics (even if 5e's art differs HEAVILY from the very distinct and certainly diverse DiTerlizzi Planescape art) so it's full of beautiful people and things, but if our culture takes another swing towards dark fantasy like what we had when GoT first got big we'll probably start seeing uglier characters again.
Of course, this verisimilitude is at the opposite end of "fantasy." If D&D were a game in a different literary genre (to say nothing of its gameplay) you might have a point, but this genre is defined particularly by how it differs from reality. 5e D&D and its flagship products are also squarely in the "high fantasy" subgenre of fantasy; a dark fantasy or horror influenced fantasy would of course take inspiration from how reality is uncomfortable and amp it up, but instead high fantasy tends to want to portray an idealized world; one where concerns like physical attractiveness and even general health and disability are not a consideration. Remember; all art is propaganda, and high fantasy borrows heavily from mythology: mythology has an incentive to portray its protagonists as physically perfect ideals of what to strive for, rather than reminders of how reality current sucks.
D&D does have some non-high fantasy sub IPs, and I'd argue that in art for those you do tend to see a lot fewer attractive characters. Greyhawk has barely been in 5e but GoS has some pretty gross looking townsfolk, and while she's gorgeous they did make a big deal about D&D's first autistic character being from Greyhawk- so that's another point for diversity there. I can probably find plenty of portly and pockmarked characters in Ravenloft art if I go looking, and Dark Sun is known for making everyone and everything hideous. Most of 5e's art is either set in the Forgotten Realms or "Planar" settings which also tend to be very high fantasy in aesthetics (even if 5e's art differs HEAVILY from the very distinct and certainly diverse DiTerlizzi Planescape art) so it's full of beautiful people and things, but if our culture takes another swing towards dark fantasy like what we had when GoT first got big we'll probably start seeing uglier characters again.