I think this makes them currently incompatible. Otherwise they seem compatible. It seems to me the existing patches for article, book, and report would work just as well with the ext classes.
\DocumentMetadata
{
lang=en-US,
pdfversion=2.0,
pdfstandard=ua-2,
tagging=on
}
\documentclass{extbook}
\usepackage{blindtext}
\title{extbook tagging test}
\author{Some author}
\begin{document}
\maketitle
\tableofcontents
\blinddocument
\end{document}