Well, this ended up turning into a bit more of a ramble than I intended it to...
I never use them! I learned pretty early in my career that I HATE putting design in a "document" format. But in addition to that I think it's not helpful for my design process and communicates the wrong information for my team.
High level information I prefer to use slideshow as outline, even if it isn't a live presentation. It's way more important people on my team understand why we're designing something in a particular way. Because when a particular piece of design doesn't work out, I find it's often more frustrating for people to have to redo something that they did, in fact, do perfectly "correctly" the first time. And then deviating from that spec, or having to rewrite it to match new design experiments adds a lot of friction and confusion. Way more helpful to have everyone see what the goal is, and understand why the attempt didn't reach the goal.
Not without it's disadvantages for sure. Not having the big GDD means you have to spend a lot of time building that understanding and buy in. It's harder to communicate the game to external partners (eg publishers, contractors). It's easy to be very underdocumented since you're not just updating some single central thing often. It's easy to desync with team members, especially remotely, when design shifts. It requires a lot of time from vision holders to just be communicating with everyone. And it absolutely does not scale well because it's hard to keep larger groups on the same page.
But I go without them because it's more true to the game process, and process is everything! Design isn't real until it survives contact with playtesting, and once you hit that point you already have the design. And if instead it dies in playtest, you can iterate faster. You can't always avoid writing specs, but when you can, you saved time, work, and kept your team doing what they're good at instead of generating documents.
So yeah, I hate them, not just because they're never true, but because putting it down concretely on paper gives it weight it should not have! Games never go to plan! That's not a flaw, that's the process of creating art. And while having "the big plan" might be useful for some people, I find it more confusing! I think game developers, designers, and production teams should be building process that reflects reality!