Personal anecdotes, I've had HAGS enabled for a long time and haven't had any issues.I'll test it again but with Death Stranding I saw a noticeable improvement. For example in the safe room it was hanging on 92 FPS and with this method it went to 110-120.
SpecialK afaik doesn't work with death stranding.
edit: no ok it might be that the room I'm in is different somehow because I still have 120 FPS even when disabling HAGS, so it wasn't it!
SpecialK though, I'd never use unless it fixed something big like making the Crash Nsane Trilogy run uncapped. That thing just causes more problems than it solves.