I've never known ddrescue to be able to downsize reliably.
You're right, it's not an out of the box supported function. It's possible to do, but it's neither convenient nor save (as discussed above).
What's your use case with this? Will you need to do restore-down operations on every image you take, or once in a blue moon? You can in theory edit partitions inside of a DDRescue image, but I'd personally suggest (if this is an occasional task) restoring the image to the same size drive, resizing the partitions, and then cloning your edited drive to the target drive.
To dig into this a bit more, here's the technical difficulty (and why this isn't a pre-fab thing in a lot of cloning software). Remember that MFT that
@lcoughey was talking about? It's a backup of part of your master file table. It lives in the middle of your partition, so in case your MFT dies, it can restore from backup.
A partition resize operation looks at the free space on your drive, and then moves any file fragments and the MFT (and other particulars) inside the specified area of the new smaller partition, and then updates the partition table with smaller values for the partition. When you're creating an image, the image software on some level specifies the location of the data, and ranges of sectors as free space. It's no easy task to calculate this on the fly from an image file that is larger than the destination to see if it will work (not to mention how file fragments complicate this, as moving them will require changes to the file system so they don't get lost).
I think a restore to a temp drive, a partition resize, and then a clone to the target drive is your best bet.