It's largely an ivory tower ego playground for the financially elite, but with a creative side. It's a lot of relentless self-marketing with a generous helping of whatever buzzwords are in at the moment.
The designers are easy to spot. They wear boldly coloured look-at-me glasses and clothing. It's like a menagerie of rare birds. Find them at international Expos, Bienalles and design festivals (if in doubt, seek out a pavilion).
Their ideas are largely stale and reused. These people are born rich and die rich and affect very little positive change in the time between.
But - remove the glamour and apply design thinking to hard, thankless but important problems and it can be a pretty meaningful and worthwhile profession IMO.