I imagine a mechanic would go about it similarly to how any of us would, with the exception of having a lift for easier access to the underside, or maybe having a few more common culprits in mind.
Mine (VG engine) has a brief rattle on startup, especially if it's cold, especially if it's time to change the oil. That's just the lifters making noise until they see oil pressure, not sure if this is as common on the VQ. There is another ticking on mine that is worse when cold, and worse under load, and that's the exhaust leak. An exhaust leak at/near the engine can sound surprisingly metallic, and if it's a small leak, it may close up a little as the system warms. I don't know the VQ's weak spots for exhaust leaks, but if you're staring at the exhaust, keep an eye out for soot marks. (If it was a VG30, I'd say look for broken exhaust studs, but AFAIK Nissan had figured that one out by the time the VQ came out.)
Could be a heat shield no longer has room to rattle when the system is warm. I don't know the VQ well enough to say it's definitely not the timing components, but I would expect most internal noises to get worse as the engine warms and the oil thins. If it was pinging I'd expect the computer to be all kinds of unhappy, and if the knock sensor wasn't working, I'd expect it to complain about that, too. If you want to rule out a lean burn, check a spark plug. I worked on a friend's Buick once that was running lean and going into limp mode if he stepped on it. I suspect it was running lean and pinging, and the knock sensor was triggering the limp mode. All I know is the plugs were white and the MAF was filthy, and cleaning it resolved the issue. Doesn't sound like your issue.
I like the idea of brakestanding it to see if you can make it act up, but, yeah, I wouldn't roll under a brakestanding truck. I'll bet you could clamp a pair of vise grips to the the shield you suspect of making noise, and take it around the block, and see if the noise goes away. Even if you can't vise grip the shield to something solid, I would expect the weight of the grips hanging off the side to silence the rattle, or at least change it somewhat.
I have removed loose heat shields without issue. Easy when they're rotten. Harder when they're still welded/bolted on most of the way around.