As example, some software pushes out updates that can (and sometimes will) break your setup.
Of course nobody pushes out something like that on purpose to mess with users. But mistakes happen all the time. And even if the dont, some version upgrades require the user to take manual steps, when these are ignored and with something like Watchtower just blindly upgraded, setups can and very likely will break.
Imo its not worth the very short amount of time saved by automatic-updates versus the amount of time it costs to fix such a mess when it occurs.
For example, NPM (Nginx Proxy Manager) had a update months ago that broke many users setups. They of course did warn about this in the changenotes, but i remember people here on sub saying "well damn i used watchtower and it updated npm overnight and i wake up and nothing works anymore, took me hours to figure out the reason and fix it".
https://github.com/NginxProxyManager/nginx-proxy-manager/releases/tag/v2.10.0