Forgive me if the question is too subjective.
I do understand what it is. No need to explain that, please.
I just don't get why people find it useful. Same for live reload. The act of pressing CMD+R isn't something that takes time. If the actual refresh takes significant time, seems like one should just fix their dev environment.
I have a trust problem with such things. Seems too likely that they'll end up causing bugs. I fear that I'd spend an hour tracking down a bug only to find it was hot-module-reloading's fault. Or that everything is working in dev, but breaks in prod because prod isn't using hot-module-reloading and dev is. Perhaps this fear is misplaced.
I also find it tricky to know when the changes have taken effect. Seems simpler to just know that once you press CMR+R, your changes are there.