Picture a settings screen with 45 different options. Every option is a horizontally aligned button that users can choose from. However, viewing everything at once is overwhelming and creates a lot of clutter. As a result, specific options are harder to find, and current settings are harder to track.
The settings labels are on the left, and the options are on the right. When users scan across the options, they need to move their eyes in perfectly straight lines. Should their gaze veer too low or high, they'll mistake their current setting for the wrong one.