So $v$ is a unit vector which is "optimal" in the sense that $\| Av \|_2$ is as large as possible. Let $x$ be a vector that is orthogonal to $v$. We want to show that $Ax$ is orthogonal to $Av$.
If this were not the case, then $v$ would not be optimal, because we could improve $v$ by perturbing it a bit in the direction $x$!
I'll explain the intuitive idea first. When we perturb $v$ in the direction $x$, the norm of $v$ does not change (at least to a very good approximation). Imagine standing on the surface of the earth, and $v$ is the vector from the center of the earth to your current location. If you take a step in a direction orthogonal to $v$, your distance from the center of the earth does not change. You are walking on the surface of the earth.
However, when $v$ is perturbed in the direction of $x$, the vector $Av$ is perturbed in the direction of $Ax$. And if $Av$ is not orthogonal to $Ax$, then the change in the value of $Av$ is non-negligible. So, by perturbing $v$ in the direction of $x$ (or perhaps opposite the direction of $x$), we obtain a unit vector $\tilde v$ for which $\| A \tilde v\|_2$ is larger than $\| Av \|_2$. This shows that $v$ is not optimal after all, which is a contradiction.
That is the intuition, and it is simple and clear. It remains only to convert this intuition into a rigorous proof.
To get a rigorous proof, we will have to deal with the fact that $\tilde v = v + \epsilon x$ is not actually a unit vector, even though its norm is very close to $1$ when $\epsilon$ is tiny. So, we introduce the normalized vector
$$
\hat v(\epsilon) = \frac{v + \epsilon x}{\sqrt{1 + \epsilon^2}},
$$
which is a true unit vector. Let
$$
f(\epsilon) = \| A \hat v(\epsilon) \|_2^2.
$$
Because $v$ is optimal, we see that $f'(0) = 0$. And if we compute $f'(0)$ explicitly (which is a straightforward calculus exercise), we will find that $\langle Av, Ax \rangle = 0$.
Here are the details:
\begin{align}
f(\epsilon) &= \frac{1}{(1 + \epsilon^2)} \langle Av + \epsilon Ax, Av + \epsilon Ax \rangle \\
&= \left(\frac{1}{1 + \epsilon^2}\right) \| Av \|_2^2 + \left(\frac{\epsilon}{1 + \epsilon^2}\right) \langle Av, Ax \rangle + \left(\frac{\epsilon^2}{1 + \epsilon^2}\right) \| Ax \|_2^2.
\end{align}
Using basic calculus we see that
$$
f'(0) = \langle Av, Ax \rangle = 0.
$$