Decoration is best, except when it isn’t
Decoration and module extension are both viable ways to compose objects in Ruby. Which to use is not a simple black-or-white choice; it depends on the purpose of the composition.
For applications where you want to adorn an object with some extra functionality, or modify how it presents itself, a decorator is probably the best bet. Decorators are great for creating Presenters, where we just want to change an object’s “face” in a specific context.
On the other hand, when building up a composite object at runtime object out of individual “aspects” or “facets”, module extension may make more sense. Judicious use of module extension can lead to a kind of “emergent behavior” which is hard to replicate with decoration or delegation.