Obviously BOs are engineered so you know the parts in question can take the loads suggested (well you hope). At one point only custom bikes had all the BOs we now take for granted, which means you could buy a perfectly good touring specific bike like my Peugeot from the 70s, and it had all the gear (save front racks), but fenders, rear racks, lighting system, pump pegs and generators, and it was all banded onto the frame. So it isn't the end of the world to have clips, but carbon does not do well with compression. The cleaver way to attach stuff to carbon if it isn't designed for it is to lash it in place, or use tow and epoxy. Fittings like BOs are neat and all that but not a good way to engineer stuff only carbon tubes, but they are what people are expecting to find.
If you look at the end of the boom on this highly sophisticated maxi-cat, you will notice the load take off is a loop of white webbing. Before carbon booms became the rage that would have been a metal fitting like a BO on a bike. But two things changed, they had to adapt to what carbon likes, and when sailing non-stop around the world in 80 days or less, cordage is king. The other thing is that modern day cordage is cheap and stronger than steel, so you have a toofer. Cordage would have been crazy and worn through from chaffe in the old days, but it is the new normal on boats. You can get a difuse load transfer without any significant preload on your tubes.