Emacs key bindings work system-wide on macOS. Having the same keys to navigate no matter what app you’re in is a huge productivity booster.
Yank works 90% the same, which is close enough to be useful but different enough to be annoying, daily. Repeat count is disabled by default. Transpose is broken in Xcode 10, and I heard Xcode 11 fixed it but one of my Macs can't run (the macOS required for) Xcode 11 so I'm hesitant to upgrade.
And of course if you use Firefox, they've implemented the whole GUI from scratch, and didn't bother with half of those, despite bug reports having been filed literally decades ago.
I get the feeling that Emacs keybindings on the Mac are like map/reduce in Python: it got snuck in version 1 by a fan, and the maintainers since then haven't really understood why it's there or what to do with it. I fully expect it to simply disappear one of these days.