Image tag in Sundown is easier than Markdown:
:s:img http://link-to-image.jpg image alt tag
Or how about embedding a tweet: :twitter:embed http://link-to-tweet
Or, youtube, user sign-up form and more...You are absolutely right! There is a trade-off. Some tags are easier in Markdown (e.g. bold, italic, inline code and a few others). But you cannot extend markdown with your own custom elements can you?
Sundown by itself is not that useful. It gets really useful when you use it as a preprocessor for your own custom HTML tags.
Here I explain how you can create your own server-side HTML tags:
https://www.sunsed.com/manual/creating-tag
Again, Sundown is just a HTML preprocessor you can write all of the above tags like this:
<s:youtube>
http://youtube-link
</s:youtube>