Yes, Gift is fast to create bulk questions but also often the questions are coming from elsewhere and need manual massaging into something importable.
I work with one site where the questions are made by professionals in their field in excel and go through another layer of scrutiny and then arrive at me.
And in another site, I scan and OCR the questions from (lots of) old tests and they come out almost looking like gift format. I just go down the list adding the little bits and pieces I need.