Meh. Only relevant if you need to pull more than 15A or so. There are plenty of portable air conditioners for sale in the US and most are happy with 110V and less than 15A.
> HN is mostly a US based website
This sounds like gatekeeping. There are lots of readers from all around the world.
> Secondly - you're not hanging air conditioning units off the exterior walls of the apartment
In the US. This is not particular to Japan. In fact, I'd argue that this is the most common air-conditioner setup worldwide, with building in many countries providing supports for either split systems or, more commonly, 'window' units.