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This question is a piece of the small talk death conversation. I don’t feel it should be asked unless you want to know. But that is me. I also loathe small talk, I feel it’s for people who can’t handle silence and thus demand energy from other to full said silence.
Others ask it like it’s the equivalent of “hello”. Saying the truth is like hearing “hello” and then talking about your life. Saying “hello” back is done by saying “fine”.
Where this messes up the human metric is the habitual responding. A provider enters a room in the morning to ask a hospitalized patient how they feel. Instead of responding honestly the patient says “fine”. Provider leaves to move onto the next patient. After the provider is gone for that day the patient realizes their error, or doesn’t understand why the provider disappeared so fast.