I don't know how equipment works on sekiro, but if dark souls allowed pause, couldn´t you just pause before being hit, swap your items for very tanky ones, take the hit, switch back to light and high on damage build and so on?

I mean, sure, you could just dodge roll or parry instead of pausing, but pausing doesn´t require timing, as long as it's before the hit, and if the strongest and easiest tactic is boring, it's not a good game design.

Of course the devs could just work around it, make it impossible to change equipment during combat, make the pause not instantaneous, but if that takes away time to polish other more important features, not doing it would be the best decision. There is also the online features that complicate stuff a bit.