For instance, Linus Torvalds (a very smart person) resisted using something stronger than SHA-1 for Git because he said the purpose of hashes isn't security, it's content-addressable lookup of objects. Which may have been true at the time, but then Git added commit signing. Now if you sign a commit, no matter how strong of an algorithm you use, the commit object references a tree of files via SHA-1. Git is currently undergoing an extremely annoying migration to support new hash algorithms, which could have been avoided.
Also, BLAKE3 is faster than MD5 and also far more secure, so if you're saying "It's okay I'm using MD5 because I want a faster hash and SHA-256 is too slow," there are options other than SHA-256.
If the thing you're trying to hash really really isn't cryptographic at all, you can do a lot better than MD5 in terms of performance by using something like xxHash or MurmurHash.
So, even if it isn't a security vulnerability, using MD5 in a new design today (i.e., where there's no requirement for compatibility with an old system that specified MD5) is a design flaw.