OK... Either I am just super late to the party, or this just isn't very widely known / discussed in the macOS #VoiceOver community.
As of macOS Sonoma, remotely controlling a Mac using Screen Sharing is actually very much accessible using the High Performance Mode connection option. VO needs to be enabled on the Mac being controlled, which will result in VO, as well as any other audio being routed over the network to the controlling Mac. @AppleVis