Generics in typescript do not affect codegen, they are only visible to the typechecker.
The main typescript features that require specialist codegen for ESNext targets are enums (especially const enums) and namespaces. These were added in the past when typescript was less strict about adding features that affect codegen, if proposed today they would not be accepted as typescript now has a policy of waiting for JavaScript to implement features first.
See the last paragraph of zarzavat's comment :) They wouldn't be added today, and they aren't widely used any more (they have non-codegen alternatives now). In other words, breaking changes in semantics shouldn't be a worry any more, since the TS team has consciously decided to attempt to avoid them a few years ago.
The main typescript features that require specialist codegen for ESNext targets are enums (especially const enums) and namespaces. These were added in the past when typescript was less strict about adding features that affect codegen, if proposed today they would not be accepted as typescript now has a policy of waiting for JavaScript to implement features first.