If I configure me.example.com to accept emails matching the pattern "me<anything>[email protected]", then I can generate as many on-the-fly unique emails as I want, without maintaining any lists, and without catch-all forwarding of random spam to my inbox.

If I use [email protected], I get the same exact feature, but the downside is "+anything" is recognized by some and either disallowed or used to generate more patterns.

If I use subdomains (like [email protected]) I have the spam issue.

With a white pattern scheme, you can choose your own pattern (so sites can't really catch on), not have to maintain any lists, and avoid spray-and-pray spam.