CAPTCHAs being american-centric, ableist, etc are all valid criticisms here, but I think people in tech fail to understand the value of them.

Being "robot-friendly" still doesn't mean it's a walk in the park, and it's a hurdle that spammers will have to account for. If your site is a low value target or the spamming in general is low-value, it's often effective. Running any sort of small time open to the internet blog or forum will make the value of CAPTCHAs abundantly clear. The issue here is being inclusive to people, not making them "work" against robots.