In general, I think that most of these companies manufacture it how they claim.
This seems self-evident, it's easy to check that a claim such as "the fuse is made from 95% silver/5% gold wire" is true and there is trading standards legislation in most of the world which can be brought to bear if it turns out the wire is made from highly polished brass.
Most of them do actually believe this stuff, and that what they are peddling actually makes a difference as they claim.
I find this a harder pill to swallow. At least not if the people behind the product are conventionally sane. None of these things produce an objective (i.e measurable with test equipment) or even reliably subjective (i.e reproducible in double blind trials) difference - if there's a decent engineer anywhere near the design and manufacture of these items the lack of tangible benefit must be obvious. At the very least there's a deliberate avoidance of reliable comparison techniques in favour of flowery language in descriptions.
Admittedly audio is a minefield of perceptions, psychology and personal taste. Even when you can measure things it's often the case that a signal degradation actually "improves" the perceived sound. The right type of distortion sounds "nicer" and more "musical", the right amount of echo and reverb sounds "fuller" etc etc - there's no wonder there's room for dubious claims.
They are of course delusional.
More, or less, than the people who buy it?
I must admit though that I can sort-of see a logic to the gold plated fuse. At least it is one end of a continuum that starts with something plausible and generally acceptable (gold plating for low voltage signal contacts), goes a little OTT - "if gold plating the input connectors improves that 0.1mV phono signal then it
must improve that 50V speaker signal", then AWOL - "if gold plating the audio connectors helps then we must do it
everywhere", then finally landing at the slightly bizarre "if we have a gold plated mains plug, it
must need a gold plated fuse".