If you need really small functions, yes.
emscripten is providing all the libc functions, WASM loading code and binding generators. You will probably need some of that when porting existing libraries or applications to the web!
A libc can be useful inside of wasm for existing C or C++ code (or whatever) that is built for another platform, so that you can more easily compile to wasm as well. But it's an option, not required.
I'm not sure the primary appeal of wasm is treating it as a low level target (even if that is possible and sometimes useful).