In the Philippines, mobile-first isn't a design philosophy, it's the audience. Most users hit government and clinic systems on mid-range Androids over mobile data, not desktops on fiber.
That changes the priorities: small JavaScript bundles, images sized for the actual screen, forms that work with a thumb and one hand, and pages that render before the connection stutters.
The test isn't a device lab, it's throttling to a slow connection and using the system end to end. If it frustrates you in a simulation, it's failing someone in the field.