Rails has very robust and well documented generators if you find it's a lot of work to create the migration file and the model file when you're changing the schema (I usually just create them manually though). It's a pretty standard workflow for rails developers, and given that rails is used by a lot of companies that are not "simple CRUD apps" (like AirBnB, Stripe, etc.) I'd say it's definitely very useful in many scenarios.

In fact, I'd argue that the "code-first" approach as you call it is actually more useful, because rails gives you bindings for before/after commit hooks, validators that aren't supported by SQL, etc.

> Also, unless you are a following a "code-first" approach and doing all your schema migrations through the ORM

I've literally never heard of a rails team migrating their DBs manually. Everyone uses ActiveRecord because it's a joy to use and very well supported and documented.