I'm not sure why OP thinks the exact same is a "truly horrible" usage. It's perfectly natural to ordinary native speakers, but here on painintheenglish.com is the somewhat obscure rationale as to why some pedantic grammarians object to it...
Is “She was wearing the exact same outfit” grammatical? And if so, what part of speech is “exact”?
People use that phrase all the time, and seem to think it’s correct, so from a descriptive viewpoint it is correct. “Same” is clearly an adjective, and “exact” modifies “same”, so you would expect it to be an adverb.
So what’s the problem? Well, Merriam-Webster’s Collegiate Dictionary (11th edition) doesn’t list “exact” as an adverb. It can only be an adjective (or a verb, with a different meaning). The adverb form is “exactly”. So if you take Webster as an authority, you should say “She was wearing exactly the same outfit” instead.
If you follow that link, you'll see quite a few comments after the above text. They mostly seem to be from competent native speakers, and the vast majority of them defend the usage (either by saying it's idiomatically ubiquitous, so by definition it's valid, or by taking issue with the adverb/adjective distinction as used in the argument).
Note that the exact same/exactly the same issue has been covered on ELU by The use of “exact same” and Shouldn't “the exact same” always be “exactly the same”?. Also note that because the exact same is more recent, and much less common than exactly the same people tend to look for a subtle semantic distinction.
In most contexts I don't think there is any difference, but non-standard phrasing = non-standard meaning is an established aspect of English, so it could make a difference if, for example, you used both within the same conversation...
"We drive exactly the same car!" (our two cars are the same make/model)
"To be specific, we drive the exact same car!" (actually, there's only one car, which we both drive)