Absolutely NOT from ping due to being in the middle of nowhere. That 23ms ping is the ping based on the location. It's the +22ms (total of 45ms) ping that occurs due to poor flushing of packets, leading to an effective increase in latency under load. That flag on "Low Latency Gaming" under load just means that latency has increased beyond 40ms, which, at 45ms (23ms + 22ms) it has. At 45ms, that's not a disaster for many forms of gaming (fine for locally rendered games), but it would be bad for game streaming.
+22ms is not terrible. That's pretty good.
In some severe cases, users with high bandwidth pipes can see hundreds of ms increases when under load. And "under load" does not require the pipe to be saturated, just in use. This is because the delay trigger is not necessarily that the pipe is full, but that the buffers CAN (depends on various factors) delay packet exchanges.
This will ALSO occur without CAKE, FQ-CODEL, or similar algorithms in effect if the pipe is full, but not exclusively then. Further, with those algorithms managing traffic, even if the pipe is full, Internet use will still "feel" responsive. The available bandwidth will be reduced due to congestion, obviously, but latency should remain close to the unloaded latency. And latency, far more than bandwidth, is what gives a "feel" of responsiveness for most actions to a user.
Just to show what you can expect with proper bufferbloat prevention in place, note the under load increases of only 0ms and 2ms for download and upload respectively (the 30ms unloaded is because I'm far from the server, nothing I can do about that):
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And potentially more important, depending on usage (especially for VoIP and video calling), are the jitter metrics that the Buferbloat test also shows (unloaded, under download load, under upload load respectively):
View attachment 61089
To your point, there are indeed places where bufferbloat doesn't matter much: for file transfers or video streaming. If that's all you care about, then you're correct that bufferbloat isn't important to try to manage. For those use cases, available bandwidth is king. But for VoIP, video calls, gaming (especially game streaming), and web browsing (assuming not a lot of huge images to download), consistent low latency with low jitter are more important.