The first question is somewhat difficult to answer, because it requires speculation about the author's psychology, but let me at least try to give some intuition that it is a sensible score. Recall that what it means for $\psi(W;\theta,\eta)$ to be a score is that at the true values of $\eta_0 = (\ell_0,m_0)$, we have the moment condition
$$E[\psi(W;\theta,\eta_0)] = 0$$
Let us now write out what that entails given the $\psi$ defined above. We end up with the equation
$$E[(Y - \ell_0(X) - \theta_0(D-m_0(X)))\cdot(D-m_0(X))] = 0$$
Using the linearity of expectations and rearranging, we can get a closed form expression for $\theta_0$ given the above equation:
$$\theta_0 = \frac{E[(Y-\ell_0(X))(D-m_0(X))]}{E[(D-m_0(X))^2]} = \frac{E[\mathrm{Cov}(Y,D|X)]}{E[\mathrm{Var}(D|X)]}$$
I like to think about this expression for $\theta_0$ in terms of the Frisch-Waugh-Lovell (FWL) theorem. Recall that this theorem states that in the linear model $Y = \beta D + \gamma X + \varepsilon$, $\beta$ is numerically equivalent to the outcome of the model $r_Y = \beta r_D + \delta$ where $r_Y = Y - \mathrm{L}(Y|X_2)$ and $r_D = Y - \mathrm{L}(D|X_2)$ are respectively the residuals from predicting $Y$ and $D$ using the $X$'s (here $\mathrm{L}(A|B)$ is defined to be the best linear predictor of $A$ given $B$). Recall additionally that when $D$ is scalar, the OLS is just the covariance of the outcome and the predictor divided by the variance of the predictor, i.e. $\beta = \frac{\mathrm{Cov}(r_Y,r_D)}{\mathrm{Var}(r_D)}$. Note that the expression for $\theta$ can thus be thought of as the "nonparametric" analogue of the FWL theorem: rather than taking the residual from the best linear predictor, we take the residual from the best predictor, i.e. the conditional expectation function.
Now, addressing your second point, let $\delta_\ell(X),\delta_m(X)$ be two test functions respectively perturbing $\ell$ and $m$. Then Neyman orthogonality states that for choices of $\delta_\ell$ and $\delta_m$, we have
$$\frac{\mathrm d E[\psi(W;\theta,\eta_0 + r(\delta_\ell,\delta_m))]}{\mathrm d r} = 0$$
where the derivative is taken around the point where $r=0$. To prove this, we can simply expand out the definition of $\psi$ to obtain
$$\begin{aligned}E[\psi(W;\theta,\eta_0 + r(\delta_\ell,\delta_m))] &= E[(Y - \ell_0(X)-r \delta_\ell(X))(D - m_0(X) - r\delta_m(X))]\\
&- \theta E[(D-m_0(X)-r\delta_m(X))^2] \end{aligned}$$
Let us first check that the derivative of the first term is mean 0. To do so, we note that by differentiating under the expectation sign around $r=0$, we have
$$\begin{aligned} \frac{\mathrm d}{\mathrm dr} E[(Y - \ell_0(X)-r \delta_\ell(X))(D - m_0(X) - r\delta_m(X))] &= E\left[\frac{\mathrm d}{\mathrm dr} (Y - \ell_0(X)-r \delta_\ell(X))(D - m_0(X) - r\delta_m(X))\right]\\
&= -E[(Y-\ell_0(X))\delta_m(X) + \delta_\ell(X)(D- m_0(X))]\\
&= -E\left[\underbrace{E[Y-\ell_0(X)|X]}_{=0} \delta_m(X)\right] - E\left[E[\delta_\ell(X)\underbrace{E[D-m_0(X)|X]}_{=0}\right] = 0
\end{aligned}$$
Note that the two terms above are mean 0 as a result of the fact that $\ell_0$ and $m_0$ are by definition conditional expectation functions.
In light of the above, all that remains to be checked is that the limit of the third term goes to 0 as $r\to 0$. Specifically, we must show
$$\frac{\theta\mathrm dE[(D-m_0(X)-r\delta_m(X))^2]}{\mathrm dr} = 0$$
Now, differentiating under the integral sign again, we have
$$\begin{aligned}\frac{\mathrm d \theta E[(D-m_0(X)-r\delta_m(X))^2]}{\mathrm dr} &= \theta E\left[\frac{\mathrm d}{\mathrm dr}D-m_0(X)-r\delta_m(X))^2\right] \\&= -2 \theta E[(D-m_0(X))\delta_m(X)]\\
&= \theta E[E[(D-m_0(X))\delta_m(X) | X]]\\
&= \theta E[\underbrace{E[(D-m_0(X))|X]}_{=0}\delta_m(X)]\\
&= \theta E[0|X] = 0\end{aligned}$$
So once again, after some manipulation, this third term equalling 0 is due to the definition of $m_0$ as the conditional expectation function of $D$.