I've used the gamut of approaches over the years. When I first started, at age 14, we had no where to play, so it was all 'TotM' and no tactics. You find 20 orcs in a 10x10 room, you got attacked 20 times. No really. We were totally the kids they based Munchkin on. I put up with that for about a year before buying the 'Advanced' game and seeking out older players... that include buying & painting a mini for your PC, it just seemed to be expected (or you ended up using some Napoleonic officer or ancients Hoplite or something the DM had lying around from his wargaming days).
Playing at an 'FLGS' ('hobby shop,' back then), we had table space but not wargaming felt or sand tables, more like folding cardtables, and IDT chessex existed yet, so it was minis on a bare surface, maybe with dice or pencils laid down to represent walls or other terrain features. So that was fun until that shop closed and it was back to nowhere to lay out minis beyond marching order. Then I found a new place, and by then hex battlematts and cardboard standies were the order of the day for Champions! and gridded ones & leads for D&D.
That finished out the 80s, then that place, the last one in the area, closed, and it was back to limited space, shortly thereafter D&D lost me as 2e bloated, so I was running Champions! (more hex-dependent than any ed of D&D was ever grid-dependent) and Storyteller 'TotM' - though back then, if you uses 'theatre' and 'mind' in the same phrase, it was probably 'Mind's Eye Theatre.'
The it was out of college, better jobs, and more space of our own, but less interest in RPGs, so board games for a few years, then, 3.0 came out and it was D&D, and, since there was table space readily available, and battlematts with a long-disused grid on the flip side left over from playing Champions in late 80s, back to minis. After like 10 years of battlematts, a friend & I constructed some 3D 'sets' - foam-core board and papier-mache - for specific scenarios run at conventions, they included an island temple, with a pull-out 'underwater' cavern, a 3-story haunted house, cliff faces, and a tower. At the same time, I was running Encounters with poster maps and tokens.
Right now I'm finishing out one campaign (highest level PC is about to hit 24th) using mini's for PCs, tokens for monsters, and old poster maps and PF flip-maps (which, yeah, just do not lay flat).
When I run 5e, of course, it's TotM - same with 13A.