The only time I use a metronome is for recording, and I cannot recall in the last few years using one without the accent. When I'm recording I choose the methods based on the work flow and results, it's not about trying to make things harder in order to make myself improve as a player. I've done all kinds of things to make it easier. Self consciousness is the #1 performance issue in recording, so anything to bump up the comfort level or focus the player is fair game.
I could see that for some rhythmically complex music being built via overdubs, it would be easier to just not use an accent, rather than, say, build a complete tempo map, or customize the accents for each player. I haven't run into that.
The other practical use for a metronome in my life is to prove to drummers when they are unintentionally changing the tempo, but I haven't done that in years, and that was just one time because of a severe case of drug induced denial. It's basically a public vote of no confidence, for emergency use only.