-48 to 48 claims something like 97% (load dependent of course). It also needs to arbitrate between two input supplies for glitchless redundancy, plus have PM bus and other spec mandated stuff. There is no technical reason why you cant go -48 -> 12 as you state with good efficiceny, but we cant get hold of a part that ticks all the boxes.

Horrific performance by my definition would be 48v to say 1v. We only realistically use buck topologies for POL supplies. Such a ratio is really bad for current transients, not to mention issues like minimum on times for the controller.