I live on the east coast, but I have friends in Vegas, so when I visit, I avoid the Strip and touristy areas unless I want to specifically go out.
As a kid, I remember our family visiting Vegas multiple times as tourists; going back as an adult has felt very different. It was a fascinating transition to experience, not unlike when you stop flying window seats and start flying aisle seats instead.
In my teenage years, I lived in an east coast city with a boardwalk and beach, lots of hotels and condos and tourist shops. I hardly ever went to the beach -- it could get crowded, and parking and not getting your car wet and sandy would get complicated, so I often forgot that it's an option. All of that works a lot better if you're staying at the beach.
I suppose Vegas residents may feel similar about the Strip or Fremont Street during an average day, when they're trying to get stuff done. But if you're looking for ways to spend an afternoon or night out around town, there's plenty of variety, from shows to shopping, paid attractions, pedestrian spaces, museums, diverse restaurants, bars, nightclubs: much more so than metros of a comparable size: Charlotte, Sacramento, Cincinnati, Kansas City, Columbus, Cleveland. Its weakest areas arguably sports, and smaller "local" venues for bands on tour.