Actually, it does. If you go back to Xcode 3.2, open Interface Builder, and create a Carbon application window, the set of widgets it gives you to work with is largely different than when creating a Cocoa window. Also, the way the system draws windows is different between Cocoa and Carbon - for instance, Cocoa stretches the titlebar's gradient across the width of the titlebar while Carbon tiles it.
And of course, features that we've taken for granted in Cocoa applications are not present in Carbon counterparts - at least without extra effort on the developer's part. These things include spell checking, grammar checking, the Command-Ctrl-D dictionary popup among several other things.
Also, while it's not true in all cases, many carbon applications have ancient codebases with years of code fragments and bloat scattered throughout, sometimes leading to a more "clunky" experience for the user.