For racing games, and simple games like Gauntlet, a console controller is fine. Even more complex platformers like Banjo & Kazooie play just fine with a controller. Unfortunately I have found myself getting mauled by any random monster while I hold down the X button on my Xbox controller while frantically pulling the left trigger, going from item to item, until I find the object need to help stomp the monster. I currently have about 30 items in my inventory that all go by when I x-trigger my way thru. On a keyboard, I could (coulda shoulda woulda) program each number key to a specific item.
In certain situations, you need two or three items to kill something (eg, paralyze it with the Dwemer Jinxsword, sap it's willpower with an enchanted ring, and then hack the thing to death with an axe). Man that sounds dorky. Well, it's even dorkier when you have to fumble thru it with a console controller. :^/