I'm guessing you are intending to use the rample for percussion and then have 2 voices - the instruo oscs (as 1 voice) and the atom (which if it was me I would replace with a mutable rings - which would reduce the trimmers and improve ergonomics)
not sure I would want 3 identical oscillators either - I can see the point of 2, fat detuned bassline, but you could easily drop one and then fit in an effects unit such as fx aid xl (variety and ergonomics again!) whic would address your point 1
point 2: most eurorack modules are mono so I'd keep as much as possible mono until final mix stage and the dtm is a great little sub-mixer, as it can be overdriven easily to add a bit of grit - which might sit nicely with the instruo oscs - plus you need sub-mixers to mix the instruo oscs (if you are going to use them in a mono-voice anyway) before sending the signal to a filter) - I'd consider dumping the q-mix and replacing it with a wavefolder of some sort
point 3: personally I'd only need one s&h in this size case - I'd drop the divkid before kinks - the rectifier section is very useful!
point 4: I'd remove the ALA DVCA and the panning mixer and patch my own using a mutable veils instead - both panning and crossfading are easy to patch with cascading vcas!!!
I'd probably also replace the atom with mutable rings - better ergonomics and a bit smaller - not a big fan of the tall trimmers which you seem to have a lot of
this would free up a bit of space which I would keep free - you'll inevitably reach for a specific function at some point and not have it, so need a little space to add it in later
"some of the best base-level info to remember can be found in Jim's sigfile" @Lugia
Utility modules are the dull polish that makes the shiny modules actually shine!!!
sound sources < sound modifiers < modulation sources < utilities