I think it's a matter of whether you're programming in a mostly applicative way† or in a more imperative way. Especially in the modern age of generational GC, Lisp cons lists support applicative programming with efficient applicative update, but sacrifice efficiency for certain common operations: indexing to a numerical position in a large list, appending to a list, or doing a lookup in a finite map such as an alist. So, in Common Lisp or Scheme, we are often induced to use vectors or hash tables, sacrificing applicative purity for efficiency—thus Perlis's quip about how purely applicative languages are poorly applicable, from https://www.cs.yale.edu/homes/perlis-alan/quotes.html.
In general a sequence of expressions of which only the value of the last is used, like C's comma operator or the "implicit progn" of conventional cond and let bodies, is only useful for imperative programming where the non-last expressions are executed for their side effects.
Clojure's HAMTs can support a wider range of operations efficiently, so Clojure code, in my limited experience, tends to be more purely applicative than code in most other Lisps.
Incidentally, a purely applicative finite map data structure I recently learned about (in December 02023) is the "hash trie" of Chris Wellons and NRK: https://nullprogram.com/blog/2023/09/30/. It is definitely less efficient than a hash table, but, in my tests so far, it's still about 100ns per hash lookup on my MicroPC and 250ns on my cellphone, compared to maybe 50ns or 100ns respectively for an imperative hash table without FP-persistence. It uses about twice as much space. This should make it a usable replacement for hash tables in many applications where either FP-persistence, probabilistically bounded insertion time, or lock-free concurrent access is required.
This "hash trie" is unrelated to Knuth's 01986 "hash trie" https://www.cs.tufts.edu/~nr/cs257/archive/don-knuth/pearls-..., and I think it's a greatly simplified HAMT, but I don't yet understand HAMTs well enough to be sure. Unlike HAMTs, it can also support in-place mutating access (and in fact my performance measurements above were using it).
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† sometimes called "functional", though that can alternatively refer to programming with higher-order functions