Some tanks use more of certain things in the salt mix. Tanks with heavy amounts of SPS use a lot more calcium than a tank with sofites in it - for example. Softie tanks with heavy coralline algae use more Ca too...another example.
So yes, some folks do need to dose to keep their parameters balanced.
Dirty/old sand tanks can have alk issues. Tanks with low pH can throw off all of the numbers...
Salt mixes are NOT made equally - some have high Ca, others have high Alk, some lack other things and some have too much of everything...so dosing does play a part there too.
Yes, sometimes folks overdo it with the dosing and that can be harmful to their corals.
...and that's why testing is so important