I'm not that familiar with screen readers, but I have used various similar programs when translating games to English during gameplay. There are a few potential issues that such programs could have with Strive, but without knowing which program you are using I cannot be certain. Regardless I doubt that any potential fixes will be added to the game, because content addition has ended and bugfixing is wrapping up. That said, the game is basically open source so anyone with the time can edit the files to fix or change anything they like.
Potential issues:
Some programs use text source data like raw html for websites, but Strive uses the Godot Engine which does not use such data formats nor expose the data, as far as I know.
Some programs use selected text to designate what to read, but 99% of the controls in Strive do not have selectable text. It is possible to edit the properties of most of these to allow for selection, but it could be a tedious process.
Some programs scan images for text, but this is susceptible to color contrast and font style and size. While most of Strive's text allows for resizing, there are no options to change the font style to something less fancy and no options to control color contrast. There is no text in images so all text should be editable. It is easy to replace the font file with a font file with a simpler font, so long as the name of the file remains the same. Fixing the color contrast of the text could be quite challenging as there is a variety of background colors and text presentation styles.
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.
