Yes, it's certainly true that reads from the homepage selection will be a much more random selection of people. But I would say that by staying for 30 seconds, clapping, commenting, at least some of them - several hundred - have 'opted in' to that content.
After all, I never read the web design or self-help stuff that's often featured there.
And if the Medium metrics focus on the concept of 'Follow', 'Who to follow', and the earnings formula rewards 'followed you from article', you'd assume that the idea of establishing and fostering a link between readers and writers is seen as an important distribution function.
It builds loyalty - people stick with a newspaper because their favourite columnist writes there.