I think a lot of this stems from so many people making so many different choices about terminology that people simply get confused or forget -- i.e., it isn't necessarily a sign of discomfort or disapproval when people say "friend" or something. Far from an indication of homophobia, it may even be because that's what their gay brother calls his spouse.
Conventional terms like "husband," "wife," "spouse," "girlfriend," and "boyfriend," whatever their relative merits or problems, have one thing going for them: we all understand what they mean.
"Partner," "life partner," "significant other," and all the other choices we hear, are used by different people to mean different things. I know married couples who prefer "partner" to husband or wife, and it's anyone's guess whether "partner" means permanent, equivalent-to-married coupledom or just someone who thinks "boy/girlfriend" sounds too juvenile. Does "life partner" imply permanent status? Or just distinguish your sweetheart from your law partner?
Now, I'm not saying that therefore everyone must use the conventional terminology. If you're not comfortable with it, then don't.
But recognize that if you don't, people who don't know you well will be confused, and even those who know you very well will forget your preference and perhaps mix it up with others they've heard. I've been married thirty years, and I have never ever used my husband's surname for anything. Even my own relatives and friends mistakenly hyphenate me and so forth. It is a mistake to take that kind of thing personally. And I absolutely agree that that little pretend-you-don't-know-whom-they-mean game someone up thread suggested is a terrible idea. Not only rude and at best PA, but counterproductive: the person will probably be even less likely to remember if they're busy thinking about what a jerk you just were for trying to make them squirm (for the crime of asking after her spouse's health.)
Also recognize that the more couples who adopt a single convention, the sooner people will know to use it and not have to retreat to "friend" and the like. Personally, I'd go with boyfriend and girlfriend for unmarried people of any orientation, and husband and wife ditto for married, because they are the clearest, although I certainly understand the objections to all of them. (Yes, a 60-year old isn't a "boy," but we don't actually "dial" a cell phone or "type" on a computer, either, and "influenza" has nothing to do with possession by demons. Language evolves.)
So in the OP's case, to answer her question, I wouldn't say anything at the time, just answer the question about her health. If she consistently uses a term like "wife" or "spouse" to refer to Husbutch, people will eventually get the idea. But unless and until that becomes fairly universal, people are still going to forget occasionally that you are the one who likes "wife," and it's Phyllis and Louise who prefer "partner" and Todd and Josh who prefer "spouse" and Lee and Robin who use "life partner."