Earlier quoted context omitted.
All that being said, Ruby is much more like Smalltalk than Elixir or Erlang are. Smalltalk does have inheritance and classes, and does the kind of meta stuff easily that Ruby supports. Objects and classes are as central to Smalltalk's design as message passing is.
To touch on what digitalzombie said however, Kay did not originally picture inheritance as being part of OOP.
Classes in general hurt.