It matters because with 1st pick you have every player in draft available to you and chances are you have huge holes in your team.
Teams reach on QBs as they should because if you have an elite QB, picking all the other players are easy.
Name a QB that was/is elite that got ruin because he could not overcome a bad Oline.
Packers and Steelers fans always complain about how garbage

Jerry Jones wouldn't dare draft a LT if had the
#1 pick.
he doesn't have the fear of getting fired though
What if the "best" player doesn't translate in to wins.
So the dolphins did a great job by selecting the best player in the draft where they had the number 1 pick (Long) instead of reaching for someone who could have made a real difference (Matt Ryan).
Yeah, but the thing is there is a sure chance that the GM will be fired any damn way.
I much rather get fired for trying swinging and missing on a pick like

then getting fired because I drafted a LT who was a sure thing but it doesn't = wins.
Let's be real about something.
Take the top 15 LT in the game right? If you put their names in a hat and let the teams pick one to play with next year at random would it make much difference?