For example, you don't have rational numbers, so you are forced to represent everything as awkward sums. Even computing, say, three fifths of a number is a challenge under that system!
You don't have \pi to represent "ratio of circumference to diameter", so you have to use ad-hoc approximations.
You don't have notation for polynomials, so even basic equations are ad-hoc problems.
Another example: (almost) the entire work of Diophantus, the man diophantine equations are named after, is basically obsoleted by \frac{-b \pm \sqrt{b^2 - 4ac}}{2a}.
Mind you, it's not that these people were dumb. That they were solving those problems with limited tools is proof enough that they were very smart.
It's like trying to write a program in 80s Basic, at a certain point the incidental complexity is eating you alive.