Do the raw materials you find get scarce in higher difficulties? Most of the times, I was not havng space to create cocktails and bombs because I hardly used them.
On grounded you'll be thanking lady luck if you manage to find a few bullets and a bandage
Bricks become your friend, but even they are more scarce.
Definitely changes the experience, does become more about stealth/survival/being tactical rather than going in guns blazing.