I work with t-SNE on a daily basis, and also with UMAP but less frequently. My interest is not scRNAseq analysis but rather metagenomic binning, but dimensionality reduction methods don't care about the source of data. After having done this hundreds of times, I can state with certainty that clusters of dots correspond to real biological entities, and I am sure the same is true for sc-type analyses. There are numerous examples of experimentally confirmed cells or organisms that were first postulated in t-SNE/UMAP 2D plots. Non-linear dimensionality methods embed the points in ways that give intuitive visualizations and preserve local distances, but there is no guarantee that any two random points will have their distance faithfully represented in a t-SNE/UMAP 2D plot. In practice this means that cluster distances in the embedded space will most likely be preserved between groups that are relatively close to each other, and that is typically good enough for most applications.
The problem arises when one tries to understand the dynamics in sc-type datasets. As far as I know, there is no formal proof that the way t-SNE/UMAP spread the data points around has anything to do with biology. I think people believe those trajectories because they often make sense, and in many instances they might be correct. However, it is very likely that in some instances the order and connectivity of clusters have noting to do with biology, so concerns raised by Pachter and others are legitimate. Generally speaking, too many people use methods for which they do not understand pros and cons. The lure of dimensionality methods is especially dangerous because they produce such visually appealing representations that some people automatically assume they must be correct.