This game is really open, there are many approaches to every situation. Which means when things get randomized, it tips the scales of balance and you have to reconsider every option for every seed.

Even just choosing a melee weapon, you're thinking about knife vs baton vs crowbar vs sword vs eventually the dragon's tooth sword. On some seeds the knife does a bit extra damage and then you gotta think if it's better than the baton and crowbar because of its speed, and it only uses a single inventory space. On some seeds you might get a weak and slow dragon's tooth sword and it might not even be worth keeping!

And then you've got all the different paths through the levels, and you'll be rethinking routes based on random start locations, random goal locations, or random enemies in different spots, or items or medical bots. Or maybe a door was randomized to need more lockpicks and your lockpicking skill is worse than vanilla, maybe you need another way around or you choose to find the key to save lockpicks for later. You won't be doing the same thing every playthrough like vanilla where eventually you figure out which approaches you like best for each spot. The randomizer gets you to rethink it all and adapt.

The ability to do anything also means you can always progress, you don't get stuck just because you're missing a password or low on multitools, there's always another way. The randomizer really forces you to adapt.

I think any game with good replayability is a good target for a randomizer, it just amplifies that replayability.