Yeah for most teams the best players are ones with good primaries (USA, Argentina comes to mind). Uruguay however seems to have way more balanced players, look at their salaries and their DMI for example. Their salaries are low but they have good players. In U21, it's pretty rare to have a big with more than 4-5 OD. More often than not, that's the OD they started with.
A 5-outside lineup is not a good option, offense would benefit from it but you would get crushed on inside defense and rebounds. 3 guards/2bigs is a good ratio for Outside ISO (and 2 guards/3 bigs for Inside ISO). A fourth guard might be stretching it if your opponent has more than 1 good big (as is the case with NTs).
I do agree though that a switched patient could have worked in this case. But then again the game was so close it could have gone either way