I honestly don’t know how anyone manages without one these days. How would you even keep track of it all? Even if you go the ‘same password for everything’ route of horrible security, different websites have different requirements for both username and password. Wouldn’t be able keep it all straight at all.
I personally use 1password, which is better than Lastpass for sure. Probably not as good as Bitwarden, but I’m too lazy to switch a second time.