There's just too much pain (both physical and emotional) and too many diseases in the world. I refuse to believe that a higher entity (name it God or aliens) would create or simulate all those cruel things.
Just choose a disease and go for a 10 minute Wikipedia rabbit hole.
If cruelty exists in their world, then empathy and caring must exist too.
I can't explain why its insignificant, of course. It's like a hydrocarbon combusting in your car engine, and the rest of the little molecules wondering what kind of a monster could do that to them. We humans aren't even aware that it could be a problem.
E.g. even animal fights are frowned on in most cultures, and bloodsports are now pretty heavily regulated (especially vs historical norms)
To borrow a few pages out of the ancient Indian playbook, creator was really bored with perfect perfection and invented a way to entertain himself, otherwise it's a huge bland perfect nothing forever.
Fixed that for you.