I very, very rarely use full autonomy unless I'm playing a challenge where it's required. I don't play big families, again unless a challenge involves more than a couple Sims per household. In that case, I'll have full autonomy on, but check the box for no autonomy on the current played Sim and cancel any actions I deem unnecessary for them.
I've tried to play with full autonomy and it's extremely boring to me. All my Sims would do is the standard things mentioned; drink water, play video games, read books, cook meals even if the fridge is full of leftovers, and try to do other dumb things, like exercise for elders until they're ready to croak, make drink after drink after drink but never drink them and leave them to rot, do anything and everything except sleep when they're in the red zone, flirt with others than their spouse/partner/girlfriend/boyfriend, be mean to each other for no reason, shovel snow, mop puddles during a thunderstorm, etc., etc., ad infinitum.
In fact, I actually wish that no autonomy meant no autonomy. I dislike how Sims will, for instance, choose their own topics to chat about if there's nothing left in their queue, or run off to go jogging, do push-ups, get a drink, play a video game on their cell when off-the-grid, take a nap, etc. when I want them to get to know each other, or have another goal in mind. *sigh*
I much prefer micromanaging my Sims so they actually progress in the goals I have set for them. Just sitting on my hands and watching them is not 'playing' to me. Just my opinion, if others enjoy playing that way and have fun doing it, more power to you! It's just not for me. *shrugs* :)