Apart from adapting proprietary or hard-to-compile software to non-FHS distros like NixOS or Guix, what are the usecases of patchelf?
Sure it still requires you to have rights to create+run a executable.
But it's a much better model then LD_PRELOAD as it can only be used on executable you can write to, which normally means you your user/group but not other user/group owned executables. Which is especially relevant with suid/sgid.
You can also use this, to patch a library which is compiled in a way where LD_PRELOAD doesn't work. Like suid binaries. Through you have to potentially make a copy and set the suid bit again.