I have been using Vuescan for 20 years. It is tolerable for my just occasional use. While I appreciate it is very powerful, and supports heaps of scanners, it is hopeless where your workflow varies from day to day.
For example, today I scan a photo to put on a web site. Then I scan slides for archival purposes. Then financial records as PDF. Then a slide for a web site.
Different types of inputs, different format outputs, lots of manual configuration required to swap from one to the other. Saving the profile does not help when you want to change the input or the output but not both. So you end up with files for every combination of input and output.
There are many ways the workflow could be made easier but no.