* It makes searching for identifiers harder. For Nim you can't even use case insensitive search because of the underscore thing! Better practice your regexes.
* The case insensitivity rules are usually super complicated and don't apply to everything, so now it's an extra thing you have to mentally compute when coding. This is probably the biggest problem and I'm sure it has led to bugs, e.g. in SQL.
* Do you enjoy the tabs vs spaces debate? How about single quote Vs double quotes? Ugly inconsistently styled code? Well you'll love this!
* Unicode case insensitivity is actually really really complicated (this mostly applies to filesystems).
You're basically opening yourself up to an array of annoyances and gotchas for essentially no benefits.
I've literally never seen anyone use two identifiers that only differ by case, but if that were actually a big problem it could be solved just by making that illegal. You don't have to resort to the insanity of case insensitivity.