It's the all or nothing approach. Previously, you could read the patch notes (such as they were) and make an informed decision as to whether to "patch ASAP", "test thoroughly, then patch", "whenever", or "not required (e.g. telemetry/GWX crap)" on a patch by patch basis. Other than the paucity of real data and Microsoft's far too frequent attempts to slip a turd in there, that's really not all that different from any other patch system, on any other OS - unless you are compiling from source that you have looked personally diff'd and examined the changes, you are still trusting your patch provider to do the right thing; binary packages on *nix are no different from binary .msu or .exe files on Windows Update in that respect.
Now, while you can still defer the installation, you don't have that per-patch flexibility. That could potentially mean that you have to choose between breaking something critical to you (e.g. the USB webcam borkage of the recent Windows 10 update) and leaving your system exposed to some critical and remotely exploitable vulnerability instead of just patching the critical hole and waiting for Microsoft to fix the USB webcam issue. Yes, when it works, the new approach will be simpler, easier for everyone to manage, and will no doubt help alleviate some of the problems with Windows Update's seriously broken version control mechanisms, but Microsoft's track record on "when it works", has been pretty dire lately. It's also much easier for Microsoft to slip something nasty in there, again something their track record on has been pretty dire of late.
Frankly, I'm all for this latest brain dead move by Microsoft. Those that have a bit of technical nous can figure out some viable approach to patch management and additional security layers easily enough (they shouldn't have to, but still), while many of those that don't are inevitably going fall foul of a series of future USB webcam style screw-ups in the future. Same result in both cases; more pain for using Windows and a greater chance that alternatives will be considered, and anything that disrupts the Microsoft monoculture is fine by me.