You could avoid the problem of needing 2 heads by building a 15 degree V4 the same way that the Volkswagen VR6 was built.
That in mind, the need isn't there, as a regular inline 4 fits well under the hood of a car.
If you built a 90 degree V-4, it would be awfully wide, and because of that it might not fit if installed transversely. Given that over 90% of new cars built have transverse engines, this is a huge problem.
Also, the expense of a V4 would be extreme nowadays because in order to competitively produce power, the engine would have to be DOHC and have VVT. That would mean 4 cams and 2 or 4 variable cam timing sprockets.