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The links you shared talk only about spam. They do not talk about illegal content like CSAM.
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There is no single approach as no central moderation exists. That's a feature.

So it's to relay operators in combination with WoT (web of trust) on the client (and sometimes relays)

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Individual relay operators must detect and block it on their own. Same as Mastodon servers or other social platforms.

Public relays take measures to deal with this. It was an issue early on, along with China spam.

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Moderation happens at the relay level. So a relay operator would certainly ban someone posting CSAM content to their relay.
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