It does take a different set of skills to regular CAD, but I haven't found it that bad for simple 3D printed models that need to be dimensionally accurate.

I have used it to make quite a few functional prints, with the help of making sure my scene units are correct and a CAD plugin.

I haven't tried any of the cad plugins for blender, but I'm not sure how you would retroactively change dimensions in blender. It's usually simple enough to create features to a certain size, but if you need to change them later it becomes significantly difficult.

If I put some holes in something that are 1mm from the edge, but then I print it and see it doesn't line up and needs to be 1.5mm, in Fusion I can just change one number and it all updates. Doing the same thing in blender would likely be very difficult.