E.g., if you need to run a task on 10M inputs, then knowing that your algorithm is O(N) doesn't tell you anything at all about how long your task will take. It also doesn't tell you whether that algorithm will be faster than some other algorithm that's O(N^2).
But it does tell you that if your task size doubles to 20M inputs, you can expect the time required for the first algorithm to double, and the second to quadruple. And that knowledge isn't arcane or theoretical, it works on real-world hardware and is really useful for modeling how your code will run as inputs scale up.