I can't see the upside for a rusty Medvedev to play Roland Garros at this point. It's irrelevant whether he's ranked #1 or #2 for the upcoming HC fall season, which is his bread and butter and for which he wants to be fully prepared.
Yes, he's defending QF points at RG, but let's face it, he hates the surface and why risk injury if not fully prepared and match-fit which would than jeopardize his Fall season. Short of Novak repeating at the FO, Medvedev has a 550 swing back to his favor ranking points wise at the end of RG, but again, I don't think it's that important to him.
The sponsors want the players to play the Majors for major exposure so at best I could see him make a half hearted effort to show up and not play all out in the 1st round .