I think a lot of the problem here is you've allowed yourself to be hoodwinked and bamboozled by artsy-fartsy tools PRETENDING to have anything to do with design.

Design is about MORE than what things look like, and these WYSIWYG's, visual editors, and glorified paint programs are nothing more than putting the cart before the horse.

It is thus that photoshop was NEVER an ACTUAL design tool. Xd, Sketch, and Figma are NOT deisgn tools, because ACTUAL WEB DESIGN IS ABOUT MORE THAN WHAT THNGS LOOK LIKE!!! It his thus I refer to those who use such software as "artists under the DELUSION they are designers".

And it is quite delusional.

Non-visual UA's such as screen readers, braille readers, TTY, search engines. NONE of them should give a flying purple fish about your visual layout, though it's possible that what you want visually could negatively impact what markup is needed, therefor negatively impact same.

There there are the things these tools are incapable of, such as semi-fluid and elastic layout; the reason "pixel perfect" is an ignorant pipe-dream of pixel-pushing artists who can't even handle the concept of dynamic or elastic design.

Simply put design is NOT art unto and of itself. It is engineering that incorporates art as one of its many facets. It is to this end that 99% of you out there dicking around in these paint programs are NOT designers, as you are utterly devoid of the most basic knowledge of specifications, guidelines, accessibility, usability, and user interaction. If you are starting out drawing a pretty picture of what a site might look like, instead of writing semantic markup of the content or a reasonable facsimile of future content, YOU ARE NOT A DESIGNER!

That's why all of these "tools" -- much like the "frameworks" the coders cream their panties over -- are nothing more than outright scams suckering nubes and rubes alike. The end results are most always a giant middle finger to usability and accessibility.

And it's one of the reasons I consider the separation between delusional artists calling themselves "web designers" and the "front end coders" to be one of the biggest mistakes in the industry. It results in front-ends that are broken, bloated, inaccessible trash.