The extension needs ParserOptions#getUserLangObj to render errors, but a side-effect of this function is that the ParserOutput will be specific to an interface language rather than content language. A patch (342e231a224) on both wmf.8 and wmf.10 makes this issue much worse by splitting cache as soon as the Cite extension is loaded (most pages), rather than only when errors are present (very small percent of pages).
We have a fix to backport in SWAT today: https://gerrit.wikimedia.org/r/#/c/mediawiki/extensions/Cite/+/555075/
To my untrained eye, it looks like we've already had a large impact on ParserCache hit rate, maybe -10% from the usual: https://grafana.wikimedia.org/d/000000106/parser-cache?orgId=1&from=1575451836150&to=1576056636151&var-contentModel=wikitext
Update: The drop in hit rate, if any, was more like 2-3%.