One reason to use #show instead of #showtooltip is to tell apart multiple macros that use the same primary spell, but with different other details like targetting. If you just use #show, the tooltip will be the macro name, while if you use #showtooltip, the tooltips would be the spell info, which would be the same for both.
For example, let's say I have two macros for Power Infusion, one to cast it on myself and one to cast it on my mage friend.
The macros could be something like this:
Macro: PI myself
#show Power Infusion
/cast [target=player] Power Infusion
and
Macro: PI for DPS
#show Power Infusion
/target MagewithgreatDPS
/cast Power Infusion
/w MagewithgreatDPS I just cast Power Infusion on you!
Since I use #show, I can tell the buttons apart by their tooltips, which will say "PI myself" and "PI for DPS." If I had used #showtooltip, they would both just show the tooltip for Power Infusion, which is redundant, and really unnecessary since I know what PI does. And #show still shows me the spell cooldown and whether it is in range.