After reading the beginning of their user guide and a bit of the wiki page, I've concluded that NVDA uses internal data from a program to recreate the hierarchy of the GUI and locate the text. Unfortunately, this problem goes beyond Strive's scope to the Godot Engine, which the game runs on. I read a couple posts about this same issue, including a feature proposal on the GitHub for Godot, and it seems that Godot uses custom GUI code and not certain common GUI libraries that are the core for NVDA's data collection. Godot is open source and there did appear to be some programmers interested in adding accessibility to Godot, but it was not a priority for the lead programmers and progress appears to be slow.
Long story short, the problem with NVDA is beyond the scope of Strive and may never be resolved. If you wish to play Strive, then I recommend looking for a screen reader that uses the visual appearance of the text.