I’m a research scientist and mostly use it to keep up with people working in similar fields.
There’s certainly some marketing (“Check out our new paper”, “My lab is hiring”, etc), but it’s not particularly top-down; everybody does it to some extent. It’s also mixed in with actual scientific discussion, lab “hacks”, and some silly banter/blowing off steam. All in all, it’s been pretty helpful for me careerwise. I think I’ve gotten more useful advice about grant writing and papers to read than many more formal mentorship arrangements.
There are a few “blue checks”, but they’re mostly a) early adopters or b) people with some kind of public presence. As far as I can tell, neither I nor most others care about the checkmark per se. I talked about my research (twice!) with John Carmack and it was cool to know that it was really the Doom Guy, but I think I probably would have engaged with anybody equally curious about my work.