Here in Germany, we still have a lot of other fast food, like the local Döner shops, or local "Asian" shops selling mostly Chinese, Thai and/or Vietnamese dishes (usually their menus are a mix), or pizza-to-go places or the good old "Currywurstbude" (selling Currywurst of course, but usually things like Schnitzel and even burgers as well). Even my own minor city (about 250k people) also has a lot of other fast food (as in takeout and/or delivery not necessarily junk food) places on top of the usual assortment of Döner/Asian/Pizza/Currywurst. "Downtown" has a Kurdish place, a Lebanese place, a Mongolian BBQ, a Croatian place, a bunch of Indian and Pakistani places, two or three Sushi places, and I am sure a lot of others that I don't really know about. And that's not even counting the places operating as "real" restaurants.
I know a few people who go to McD because "you know what you'll get", but I personally never felt the need, the competition is better in taste more often than not, and McD are not even cheaper than most of the alternatives, sometimes even more expensive. The last time I was at McD was when I was stranded at some small train station some years ago and didn't have the time to look around and just settled with the McD located right in the station building (I would have gone with the Burger King in the same building, but it was closed for renovations). That's when I found out that the quality of their fries took a slump, at least in my humble opinion.
Personally, I'd rather have a Dürüm from a Döner shop, or Pho Tron from one of the Asia places, or maybe some Masala from an Indian place.