Tilt and shift in my opinion is a very useful function.
I have shot for many years with the Fuji gx680 as well as 8x10.
I find tilt shift to be a tremendous asset even in fashion, beauty and portrait.
For example I love to shoot fashion with shallow depth of field. With the Fuji regardless of focal length I
can do both perspective correction and focus correction.
I use shift a lot in portraits especially when shooting slightly up.
Here is an example:
I find it lets me get closer with a slightly shorter focal length for a more intimate feel
while still having faltering perspective.
Here i used swing (horizontal tilt) for keep two models on two different planes in focus
while shooting wide open:
Here are the lens movements:
Unfortunately medium format digital does not have much support for Lens movements
unless you go with a tech camera, but they are a pain to use with tilt shift due to the lack of true fast live view
Using a tilt shift with a Hasselblad H or Phase One camera I find focusing to be a pain in the ass.
Viewfinder magnification is too low and autofocus points are only in the center of the screen.
Then there is the limitation of available lenses for MFD. With the DF you are limited pretty much to the
Schneider 120mm PC-TS f 5.6. It's slow and dark.
and the 645 Hartblei 45mm 3.5 Super Rotator.
Both Canon and Nikon offer a broader range.
Nikon has :
All have automatic iris, live view and on sensor focusing on both Canon and Nikon make
focusing and setup very nice, especially when using a 2K HDMI monitor.
There are also 3rd party options for Canon and Nikon from Schnieder, Hartblei, and "toy lenses" from lens baby.
There are also adapters that let you use many MF lenses such as Hasselblad V lenses on Nikon and Canon that let you tilt shift them.