As far as I know, Worms is a normal DOS game, so the only way for that to happen should be a DOS install configured to just auto-start Worms on boot. Which makes sense as a way to keep a kid away from anything that could cause trouble.
I very vaguely recall that there used to be a very few PC games that worked as boot floppies and possibly didn't use DOS at all, but it was a rarity and Worms definitely wasn't one.
At least on the Amiga 500 you would not go through the trouble to start Workbench, only to load the game, unless you were a lucky owner of an external hard drive.
Different projects have different policies, and I don't know what SDLs is.
But they already have a lot of ports, so I trust they know what they're getting themselves into.
Some people love computers and making them do weird stuff, older computers make certain tasks feel more manageable.
That's why you don't let people who have never touched a computer write tech laws. You get results like this.
(FWIW: I suspect there are more than a few old industrial control systems and such out there that are still running DOS, just because of an "if it ain't broke, don't fix it" attitude)
But I do wonder about the practicality. This would, I presume (never done DOS development, never touched a memory extender) only run on 386+ CPUs, and maybe more importantly, probably require a newer CPU than that to run anything non-trivial at acceptable performance. So I wonder how many "real DOS machines" this can practically target.
Still, it is massively cool.
Translation: "Stop liking things I don't like!"