The gauge is used to get accurate bed leveling (especially when new to 3D printing - I don't use it much any more). That doesn't mean a slight adjustment won't still be necessary, but it's a really good starting point. I also treat each first layer thickness the same from a leveling perspective.
I use the gauge so the first layer will be exactly what you request from Cura. If you level the bed to 0.1mm while it is set to 0.1mm Z height, then you get a precise height. Again, fine adjustment may still be needed. So yes, probably +/- 50 microns or so.
It can be important for proper bed adhesion when no heated bed is present. I agree with the overthinking, but as a beginner it is one of the many things a person must get a feel for. Then it isn't complicated or difficult to adjust realtime.