The valve stem of the outer tire on a dually does need to face inward because that's the side the hole on the wheel for the valve stem is on. The wheel won't fit on the hub the other way around.
You should, whenever possible, keep the two twinned tires of a dually setup together. If one is newer than the other, it will be slightly larger diameter (due to having less wear), and that means that there will inherently be a little bit of slippage and wearing when driving straight. The two tires with different circumferences must roll the same distance in the same number of revolutions.
Having only one metal valve stem should not cause any troubles at all with balancing. The wheel would be balanced with the stem installed.