The result is security of issuance, that is near complete confidence that certificates will only be used for controlled domains (not necessary if you want to MITM of course).
Also, ACME is generally easier and more reliable than other certificate rollover processes I've seen. I'm not sure if there's in-house PKI tools supporting it?
Depends on your organisation size though. Maybe your in-house PKI is fine, but it's not for everyone!
[Note 0] Revocation is of course a mess. Let's Encrypt isn't without fault either, particularly when used internally, since OCSP responders will need to be accessible from client devices.
You need as much security on your CA as the accounts in your org with the authority to replace them with your provisioning tools.
It’s just that very specific bit in the middle, where you don’t want to expose the internal hostnames but don’t need top-tier security where having a private CA is worthwhile (assuming outbound internet connectivity to Lets Encrypt is allowed).