I also think that where you want monomophization, macro seem fine. I do not think this necessarily has to be clunky, but this is just a guess.
Using C macros to replicate Rust's monomorphism has several drawbacks: they are inherently unhygienic, even in comparison to Rust's own; you can't set type-bounds; they aren't even a part of C proper, etc.
I prefer Rust's approach with the choice between generics, macros, dyn and Any.
C macros are certainly a proper part of C and one can also certainly add type-bounds. But yes, they are not ideal. Still, if one wanted to do this, one could certainly improve them a lot for type-generic programming. I would prefer this to having macros, generics, a const expression sublanguage, and vtables.
Specialization provides more opportunities for optimizations, whereas proper type-erasure (which bars specialization optimizations) doesn't due to lack of type information.
"C macros" are a part of the preprocessor, which runs before the actual C compiler. As such, it lacks all semantical information the C compiler would have at that point, such as function implementions. In practice, macros in C serve two purposes: manipulating C source code (which Rust macros can also do, but with more hygiene); specialization polymorphism, but worse (in which both Rust's generics and C++ templates do better).
Type-erasure can be undone by specialization. In contrast, monomorphization specializes the code first, at which point it becomes much more difficult to unify it again.
Sorry, my comment about preference was badly phrased: What I meant is that I prefer to make macros better, than having all the different but partially overlapping techniques in the same language. This is the complexity I am complaining about in both C++ and Rust.
The problem with your suggestion about macros is that it misunderstands the reason why different techniques exist. While they may overlap, they have different primary niches: Rust macros provide codegen and inline DSL, Rust generics/C++ templates provide monomorphism, C++ constexpr/Rust const fn evaluate expressions in compile time, etc.
Extending preprocessor macros, aside from requiring integration into the C language proper, would likely create something much more complex and with poor DX. Specially so if it tries to fulfill all niches, as each of them often operate at different abstraction levels, with different ergonomic requirements that are often at odds with each other.
Monomorphization often forces types information to flow, whereas type-erasure considers that a bonus. As such, a compiler may accidentally introduce opaque boundaries that hide type information. Even in cases where this is the programmer's fault and the type info is truly lost, in monomorphisation, that becomes an explicit error, while, for devirtualization, since it's just an optimization, the call is silently revirtualized (until someone notices it while profiling/decompiling). One has explicit intent, the other doesn't.
I agree that monomorphization has explicit rules that force specialization, I do not think this is an advantage at all because it is too rigid and one can introduce explicitness at the language level also for devirtualization where this is needed. In this sense, monomorphization is premature optimization which limits what can be expressed at the language level and makes the job of the optimizer much harder (and practically impossible to undo the damage completely).
If just "providing my own" would help why wouldn't the stdlib benefit too? You're going to have to spell out what you think can actually work here if you want me to believe there's "no problem".