With this access you can read and write (and create,...) these "nodes". This makes it possible to completely circumvent TeX's input language, which can be a pain to program with (sometimes it is very nice though). Now that easy access to data structures and the rather nice (simple) programming language of Lua makes it easy to build rather complex programs on top of TeX.
A shameless plug is my database Publishing software (see https://speedata.github.io/publisher/index.html) which I believe takes this approach to an extreme: I can use TeX's algorithms like paragraph building, hyphenation, PDF writing and such (they are of excellent quality) and build my own software around it. I don't say that this is done on a weekend or so, but the posibilities are much, much, much greater than they were before LuaTeX was available.