This is what I'm found in the /var/log/vmkernel.log:
2013-06-01T20:38:20.605Z cpu2:5636)Loading module nvidia ...
2013-06-01T20:38:20.614Z cpu2:5636)Elf: 1852: module nvidia has license NVIDIA
2013-06-01T20:38:20.706Z cpu2:5636)module heap: Initial heap size: 8388608, max heap size: 68476928
2013-06-01T20:38:20.706Z cpu2:5636)vmklnx_module_mempool_init: Mempool max 68476928 being used for module: 69
2013-06-01T20:38:20.706Z cpu2:5636)vmk_MemPoolCreate passed for 2048 pages
2013-06-01T20:38:20.706Z cpu2:5636)module heap: using memType 2
2013-06-01T20:38:20.706Z cpu2:5636)module heap vmklnx_nvidia: creation succeeded. id = 0x410031000000 NVRM: No NVIDIA graphics adapter found!
2013-06-01T20:38:20.706Z cpu2:5636)nvidia failed to load.
2013-06-01T20:38:20.709Z cpu2:5636)WARNING: Elf: 2767: Kernel based module load of nvidia failed: Failure <Mod_LoadDone failed>
Apparently it's not seeing my graphics card, but I can see it in hardware status.
ESXi is booting to the on-board Matrox video adapter.