There are dynamic quants such as Unsloth which quantize only certain layers to Q4. Some layers are more sensitive to quantization than others. Smaller models are more sensitive to quantization than the larger ones. There are also different quantization algorithms, with different levels of degradation. So I think it's somewhat wrong to put "Q4" under one umbrella. It all depends.
Nobody actually quantizes every layer to Q4 in a Q4 quant.
This approach also makes less sense for discrete GPUs where VRAM is quite fast but scarce, and the GPU's PCIe link is a key bottleneck. I suppose it starts to make sense again once you're running the expert layers with CPU+RAM.