Well I'm pretty degenerate, so I don't particularly mind haha. I'd also hope that people know to distance themselves from stories. But in the land of stories, it seems like line between healthy and abusive is blurred, but maybe that's the reality of romantic relationships for many. I wouldn't know honestly, even fluffy light-hearted romances to me are rather twisted. Also, it may be that for many, the meaning of the word "love," doesn't just come down to what people consider "healthy" nowadays.
For example, I think "healthy" implies valuing your own physical and emotion well-being, but many might see "true love" in the willingness to suffer for the other. Maybe even to the extent of willing to die for your loved one, but overall, romantic relationship often do necessitate some degree of sacrifice for the other, but we'd say only to a certain point or something like that. Or hell, maybe not at all and you should just get out since it really is a matter of just using each other, whether for pleasure or pain. Or maybe romance to someone is eroticism, and taken to an extreme is possessive and abusive, an animalistic desire only held back by social norms. Or for instance, some omegaverse stories play around with the idea of love itself. If we are just animals and love is just a feeling, then what's wrong with treating it as such, determined by biology and what not.
I think if one looks at it more philosophically it might offer more insight, because at least that's what I'm thinking about when I'm writing stories, even the really degenerate ones. I'm usually thinking bout things already in romance, and just taking it to an extreme in order to expose it. It's not really about what I think is the right or healthy way of approaching a relationship, it's about what goes on underneath and peeling off the layers. Though I always try to redeem it in some way, since maybe even in the most looked down upon relationships, there is something beautiful in it.