The battery thing (usually a coin cell CR2032 that can supply ~13mA per spec) can be a bit mitigated with a beefy capacitor (though RF packet length and space in-between have to be appropriate for the capacitor recovery, not to brown out the system).
Usually the bigger bottleneck is the regulation, so you tune for best performance in a clean environment. Hand and body during operation are really unpredictable to model in/retune, but luckily usually adds for the better. Anyways the range of the classical RF fobs (@3xx-4xx MHz and 8xx-9xx MHZ bands) is well beyond the real world needs that the 10-20% drop of performance due to certain fob positions will make a difference. If it does, you probably have a low battery.
Next gen fobs (if they hit the mass market) are BLE and there the range performance is more critical. Dunno what will be the approach there.
What can cause problems are ornament and the mechanical key insert. It has to be extensively tested that there is no coupling with those metal parts that are close to the antenna. Problem comes sometimes when they decide to redesign a bit the keyfob without going through the tests internally (e.g. oh it's just a minor tweak of the radius of the metal ring around the fob housing...) and then the certification fails and has to be repeated (not just money, but getting the slot for it...). Some OEM might even be inclined to think they don't need a certification for such a minor change and push it to the market, making the problem worse if there is an issue.
Regarding the ornament things on fobs, there were even instances of them magnetically coupling with the wireless chargers or even immobilizers and that lead to some melting...
However he is stuck with a compromise design and knows that there are various effects that a nearby conductive body can have on the antenna's performance.
- Anything nearby will effect the tuning of the antenna. And if the antenna is no longer at resonance, then it's efficiency is greatly reduced.
- Anything nearby will disturb the antenna due to its missing ground plane, which will change both the tuning and the loading (eg impedance).
- And anything nearby will act as Directive or Reflective elements thus greatly effecting the radiation pattern (eg directivity).
In the early days, it was common for phones to have an external whip antenna, and also a socket so an outdoor antenna could be plugged in if required.
But forcing the designed to include the antenna within the body of the phone, (and without an effective ground plane) results in a mess of compromises.
Unfortunately the general public thinks that phone works by "magic", and is somehow exempt from the fundamental need for a radio to have an efficient external antenna.