Some of us are sick and masochistic folk!
I've been playing on Nightmare mode since it got patched in. Less flame fuel and no knockdown by the Alien combined with non existent resources are just some of the things that gave me hell and I loved it. The Unpredictable mod is more realistic as far as the drop frequency, search time and distance of the Alien and it can feel more cinematic cause of it. Makes it a bit easier and more fun if you're not looking for that next challenging playthrough. It was my favorite way to play the game for the longest time, makes the Alien "cheat" less by making him bugger off, so you actually get surprised when you see Stompy. And there is a mod to make Stompy silent.
Now I play the Nightmare mode with the Insane mod where the alien has muuuuch better eyesight and literally perfect hearing. It really is insane, but it is what I like. To feel like I'm being hunted by the perfect organism who will find me if I make the slightest mistake.
Far from a perfect game and AI, but it is a unique experience. Especially with mods. I have a weird, sorta special bond with Stompy. Every once in a while I get the most terrifying and thrilling nightmares where I'm Amanda trying to escape the Alien.
All the criticism people have made I understand and are quite valid. Stompy can get annoying, the Alien mechanics are not perfect. But it just strikes a chord with me and gives me fear of the Alien like no other movie, book or game has done. I'm so crazy about the game that I might even get a VR headset when the VR mod gets done.