yes but is there not more randomization , more variety of enemies in the grind ?
I don't want to "gaslight" you into thinking that PoE combat is many tacticool and such, but there is a lot of variety of content you can grind in PoE, each with it's own distinct subset of enemy types. For example there is Delve, which is a mine that gets harder and harder, the deeper you go. It is not tied to the Maps System and has it's own tilesets, bosses and mechanics. However, if your build is good at murdering monsters in Maps, your build is also just as good at doing the Delve content. Up to a point. At a certain depth you'll have to reroll into a specialized build that isn't very good at bossing or mapping, but is designed just to try and progress as deep as possible in the mine. Most players don't bother with it.
The PoE Challenges have been encouraging players to engage with most types of content it has to offer in any given League, but in Trade you can also just buy many Challenge completions as a service from other players. You can basically focus on whatever content your build is good at and buy the "annoying" Challenges.
The Altars of Lillith grind doesn't sound like it can be skipped this way.