The practical risk of skipping this step.
In destinations where an IDP is expected, driving without one can complicate matters if you're stopped by police or involved in an incident, since your license alone may not be clearly understood. Rental companies in these destinations may also simply decline to hand over the keys without one.
Given the relatively low effort involved in obtaining one, most travelers find it simpler to have the document ready rather than risk friction at a critical moment of the trip.