I use medium format because I want to get decent sized prints from my negatives that show my interpretation of the scene in front of me.
The last thing I want on there is grain which to my eye lessens the impact of the shot.
This is the reason that I use chromagenic film rather than the so-called standards of HP 4/5 - Tri X
Grain does not occur in the natural world (if YOU can see it , your spectacles need cleaning!) so why do we almost make it a given that grain should be seen in monochrome work.
Using pigment inks in my 1290 I can achieve a beautifully smooth transition of tone from black to white that could never happen if I had clumps of grain in there.