When pen & paper roleplaying games got out of their first hack'n'slash dungeon crawl phase and started to focus on storytelling, a conflict between narrative considerations and gameplay considerations evolved. People started complaining about certain things in the game not being "realistic". To which others replied "how realistic can throwing a magic missile at a dragon be?". Thus some people use the word verisimilitude ("the likeness or semblance of a narrative to reality") instead of realism. A dragon is never realistic, but his behavior can well be coherent in a story. That took care of the semantics, but the underlying conflict was never resolved.

One eternal issue is how complex a pen & paper roleplaying rules system should be. I have played systems like Rolemaster (aka Roll-master), where every single attack was handled by series of dice rolls that were cross-referenced on tables based on what type of weapon hit what type of armor. Not only was that rather a lot of work for each fight, it also had rather random results from glancing blows that effectively didn't do anything to insta-kill critical hits or permanent crippling wounds. And while it is "realistic" that somebody who is in a lot of sword-fights ends up missing an arm or a leg, it doesn't make for a very fun game if you play a group of adventurers on crutches.

Another problem was that class design was often based on what developers considered "realistic". And because magic is a kind of a cop-out from realism, spell-casters ended up doing all the interesting stuff, while fighters were reduced to dumbly swinging swords. 4th edition D&D approached that differently, considering class balance first and verisimilitude later, and that led to endless complaints how "daily attacks" from fighters were not as believable as daily spells from magic-users.

But even once you found a rules system you like, the problem of verisimilitude doesn't end. The flow of time in a pen & paper adventure or campaign is special: Interesting things tend to happen exactly in the moment the players arrive at a location. Very few people ever played an adventure where they storm the inner sanctum of the evil shaman and find that they are an hour late, the princess has already been sacrificed, and it is too late to close the gate to hell. They don't arrive at a city to find that problem with the orc invasion has already been resolved and there is no murder mystery to investigate for weeks to come. It is a bit like in a computer game, where the scripted sequence starts on arrival of the player, not before or after. That has very resemblance to realism, but is often a necessity for the game to work. In a realistic world, even a fantasy one, on most days nothing special happens to most people. But you wouldn't want to play that.

My players finished their previous adventure by storming the final lair of the vampire lord Count Strahd von Zarovich without taking an extended rest before; in spite of having been told that he was hiding behind fire they opened the secret door in the fireplace and started the final boss fight of the adventure. That is somewhat unusual insofar as players usually are aware of the "fake" timing of events in adventures. Thus players in pen & paper adventures, just like in computer games, rest up before a final fight, even if the narrative implies some sense of urgency. As a DM I might at some point play out a scene where that dawdling leads to the players being late and having to deal with the consequences. But that doesn't work for all adventures, and often I just stick to the script, even if the flow of time isn't very logical that way.