”You can set it before compiling” is such a foreign concept to the real world that it’s almost meaningless, if that is the only way to change the behavior it’s pretty crazy.
Many applications use SQLite as an embedded library; that's how it's intended to be used anyway.
It doesn't really jibe all that well with things like Python though, where you typically don't do that. But it's certainly not a "foreign concept" or "almost meaningless".
For e.g. Python you can still just set the desired parameters when connecting, which should usually be handled by the database connector/driver for you.