Maybe most people don't use focus modes or Do Not Disturb on iOS, because the current notification implementation completely ignores them, and I'm surprised I don't see it mentioned more often.
I use focus modes pretty extensively - to block certain notifications during work hours, block others during personal hours, block most (with a few exceptions) during sleep... but notifications as-built ignore the quiet notification flag on iOS. This means you either get buzzes for every enabled notification (even with phone DND enabled), or you get zero notifications at all (with watch Quiet Time enabled).
To compound this, you can only automatically enable Quiet Time on a basic schedule (which might work for SLEEP at least if your sleep schedule is consistent...) or for calendar events. You can't even enable Quiet Time when the watch detects sleep.
There is a PR to respect the silent flag and Eric responded:
pretty cool find! If this gets added, it should be off by default. Many people rely on keeping their phone in DND permanently and still receiving Pebble notifications. I like the idea of re-using the same toggle as android!
One person's bug is another person's feature 😉
I think he's referencing the toggle on Android which is something like "Respect phone do-not-disturb". Is he right that many of you keep the phone in DND and want notifications to still buzz your wrist? This is especially distracting if you wear the watch to sleep and use it as an alarm - so you basically have to manually enable and disable Quiet Time every night.
tl;dr Quiet Time as-built is largely all-or-nothing and manual, but Pebble already receives a flag from the iPhone about whether the notification should be silent (including during DND) and I'm surprised that a toggle to respect that silent flag on iOS isn't a higher priority for the community.