In some ways I think Accessibility is a misnomer -- it's the way Apple says, hey, you 20% of pro users, here's something you can try. Hence Accessibility on Mac getting a security center so apps can use those hooks to resize and read the screen the way "most" shouldn't.
I treat it as a toy box, and frankly still miss most of its settings on Android. Have a look at WWDC videos on accessibility, unlike the counterparts from Google and Microsoft which often require special extensions or apps to enable, Apple delivers the whole thing, and it really works.
Why else would Apple offer 8-9 different font sizes in roughly four font weights (normal, bold, and fonts overwritten normal and bold). Yes, some options could be highlighted during the welcome screen, in the same way VoiceOver is on a Mac at first launch. But like right-click, some things you have to turn on yourself until they sync over the cloud. But that's life. At least their settings apply across the board to all apps.
The default is just tuned for pretty to look at and show to your friends, not accessible. Fitting for a status item.
Makes sense to me.