mdbm is certainly not without limitations, but is careful about its use of mmap to an extent that comparisons with MongoDB are laughable.
There are a number of use cases where in the event of a node failure it is better to rebuild from a replica or a log. Statistically, the RAM on another host is actually more reliable than local storage. Additionally, the database does have sync'ing primitives that allow for a variety of persistence strategies... just not the traditional ACID strategy.
In practice, there are lots of cases where the freedom to ignore transactional integrity is very handy, and yes, a cache would definitely be one of them.