The design of indexes of clustered indexes to prevent fragmentation isn't entirely (or sometimes even mostly) about preventing fragmentation. It's also about preventing page splits, which can be pretty nasty operations in terms of efficiency (many times the work of a single insert) and logging.

The resulting low average page density is also more of a concern than the fragmentation itself in many cases. Sure, a page that's half empty is only wasting 4kb of memory, but what if they entire buffer pool (say 64GB of it) is on average 60% full. That's a lot of wasted memory.