Consider e.g. the "with" statement in Python[1]. Someone came up with the idea, found a way to integrate it into python and a year later, people could use it. In Lisp, you write a macro.
Now Python is a rather agile language as these things go. In other languages it would be a lot more than a year. When I was in college, my professor wanted us to use generics, but the school mandated language, Java, lacked generics at the time. So we were told to use a fork of javac that had generics added. Pretty much none of the development tools would play nicely with this, and javac was at least two orders of magnitude slower at compiling than my preferred java compiler at the time (jikes).
None of this is world-ending, but it really is annoying. The argument for macros is just "what is the next generics/with/whatever feature that your language is missing." Most of the features that lisp programmers use macros for have made it into modern languages that continue to evolve, so the leverage narrows. In the late '90s it was probably a much bigger multiplier than today.