Thanks @Thalie for sharing your thoughts!
Our aim is to find a good balance between file names that will be unique and relatively short and meaningful. That's why by default I thought about adding a suffix with a few random numbers. There are different projects in terms of size and needs. In case of huge projects we want to allow doing things like you described (uuid + timestamp or anything else) and for very small projects we also want to allow disabling any suffixes but not by default. It would be a decision people responsible for creating forms would need to make.
Yes this seems to be important. If we decided to implement this feature without a mechanism for keeping those file names updated it could do more harm than good in some cases.