Don't matter to me at all- I'm plenty old enough to not care about my content's 'appropriateness'. If I'm playing with a kid, I'm going to base my choices on the content of the game as I've played it & the kid's gaming habits. Years ago I babysat a first grader- I let him play Zone of the Enders on PS2. It's rated M- so that means I'm terrible, right? But you see, the M-rated content (blood, violence, existential issues) is all in cutscenes. This kid never, ever watched cutscenes. Meaning as far as he knew, he was a robot beating up other robots.
I feel like the ESRB is less about actually informing people about game content, and more about placating politicians and absentee parents into believing they actually have agency in controlling what their kids play without putting in any real effort.