Multigen is good for creating a very efficient 3d model. It doesn't have all the bells and whistles that 3dsmax has, but multigen is getting better by adding features that are commonly used in 3dsmax, ie expanded materials for normal mapping, specularity, bump, ect.... They just added support for shaders a few versions ago.
Most model I've seen built with 3ds max aren't very "clean"...i guess that would be the appropriate word. I guess that has more to do with the modeler than the software, but I've found it's far more easier to built an optimized low poly mesh in multigen than with 3ds max. There's a learning curve for the software, and sometimes when I use 3ds max, it's like starting all over again. Even things like rotating your eye point in 3ds max is a pain because of the muscle memory from using multigen so much. I'll be hitting the wrong keys and mashing the mouse around trying to get the model to rotate in 3dsmax.