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Obviously it's not great for non-psychiatrists to diagnose mental illness in people they don't know. So I wouldn't attempt it, except in those rare cases when someone has so much influence that their mental health is a matter of public concern, e.g. Trump.
Things are complicated even more by the strength of the outrage industry, in which fortunes can be made by promoting lies. How are we to know whether Musk believes his more irrational theories? Perhaps we'll get some clues if he takes his ADL beef all the way to a court hearing.
Recent decisions spanning the past 8 years. Guy’s cursed with money, power and popularity, he was already up against the odds for preserving a state of good mental health. Add some psychotropic use and a penchant for blurring the line between scientific thought and fantasy, and I wouldn’t be surprised if he eventually outright snaps.