Djokovic pre-prime at the USO 2010? LOL, that's a new one. It's not the same 2007 than 2010, 3 whole years later. Djokovic may have been pre-prime in 2007, as he had no Slam wins. But at the USO 2010, Djokovic was a Slam winner (on hard courts, precisely).
At the USO 2010 Djokovic was already at his peak. In effect, at the US Open 2009 Djokovic lost in 3 sets to Federer. The reason? He was not at his best. But then in the USO 2010 SF Djokovic defeated Federer in 5 sets, the same result that happened in the USO 2011 SF against Federer as well. The reason? Djokovic was already at his best both at the USO 2010 and the USO 2011.
Some people have created the excuse that Djokovic was not at his best during the USO 2010 just to dismiss Nadal's victory. It is not like Djokovic was non-peak the 31th of December of 2010 and suddenly became peak the 1st of January of 2011. Djokovic was already at his peak during the last months of 2010, beginning particularly at the USO, as demonstrated by his victory over Federer.
As for excusing the Medvedev's loss, you are better than that. Djokovic was unclutch. That's it. Novak had won 3 consecutive Majors, and was the best player in the world. While Nadal exhibited his mental strength and kept the faith in the 3th set against Medvedev in the AO 2022 final, Djokovic succumbed to pression and started to cry (losing all hope) in the 3th set of the USO 2021 final.