This in turn puts constraints on the primordial quantum fluctuations that were inflated during the inflation phase, and backtracking through simulations it puts constraints on the entire dark matter and matter history from now back to age 380,000 years.

Either what we know about black hole formation is basically complete (it goes gas -> star -> black hole -> accretion + collisions) but the environment in the early universe was sufficiently different/dense that parameters which rule out the formation of supermassive black holes now were different. Maybe there were many intermediate black holes just in the millions of years after the big bang and things were still close enough together that accretion could happen and collisions were "likely" at the rate needed to form SMBHs after just a billion years. If that is true we might expect to see many many active galactic nuclei as we get better telescopes and look further back, depending on how quickly such black holes formed.

The other option is there is a mechanism of black hole formation that bypasses the above chain which we understand. People talk about supermassive stars, gas clouds collapsing directly into black holes, or primordial black holes that existed due to essentially random distributions of density moments after the big bang causing some regions of space to collapse into massive black holes which then persisted. Such things are far more difficult to observe, but could be inferred if we don't see many many active nuclei as we get better telescopes but all other indications of the accuracy of the big bang + inflationary theory hold true.