This is something I'm a bit curious about as well. I'm currently enrolled in an art program, where I expect to be modeling human characters from scratch before it's all over. But I've looked at some of the programs like Make Human. And I've even heard people who are more in the know than me talk about using things like DAZ studio and such. I think there are advantages and disadvantages and I'm still trying to learn what they are.
For indie developers who are more game developers than artists, these seem like really useful tools to me. Even if you're an artist, what if you need 400 individual human models for the game!? That's a lot of work. Having a program that can crank them out quickly may make some sense. I mean, think of Grand Theft Auto. There's all sorts of human npc's that you come in contact with that are not main characters. You may want to spend some time on important characters, but in a case like this you need to crank them out in volume. Seems to me that a program that can help you with that would be useful.
I've only done 2 or 3 human models in my life so far and they were all following tutorials. Taking the artistic approach of actually modeling them, it would seem to me that you could get a base mesh fairly close that you could then use as a template so that you would not have to start over from scratch for each character.
I've also wondered about games where the player designs the character like Skyrim or the Sims. Seems you would have to have some artistic skill to create that. Make Human or DAZ studio or such are not going to help you there. There you need the artistic skill to kind of create your own "Make Human" inside your software.
I've been thinking you could standardize vertex positions where the body parts connect. For example, if you make it a rule to use the same ring of neck vertices, then you know that if you produce another head it will attach to the existing torso, allowing for character customization although not to the same degree as Make Human.
But if you just want a single character, like in Tomb Raider, then Make Human like programs make a lot more sense.
My experience with Make Human though, was not particularly great. Clothing and hair options are pretty limited. Plus, should clothing even be done this way? You're layering clothes on top of a body mesh, although there is some sort of option to hide the polys below the clothing. Does that actually delete the hidden geometry or just hide it from view? The models are probably not particularly optimized for games. I'm still a pretty beginner 3D artist, but I tend to want a very low poly count model with a good normal map produced from a high poly model. I doubt this would be much different. Make Human doesn't make that easy, if you can do it at all. I just used the overly high poly model. There's an option to export a low poly version, but I don't think it's conducive to baking normal maps and it looks pretty bad. Other programs may be better at this, but what I really need the program to do is output a low poly mesh that appears to be far more high poly than it actually is because of the normal map. Humanoids especially seem to me to be a good candidate for this technique. And clothing really looks far more realistic when you can add 3D wrinkles and such. You certainly don't want a high poly mesh in your game. Not for a commercial game anyway. Make Human appears to not even create a normal map for the body. (I see one for the hair.) I would prefer half as many polys and a good normal map that makes it look much higher poly than it is. I'd like 10,000 triangles with a normal map produced off a million triangle model.
I brought the high poly mesh into Blender and skinned it and rigged it by hand. This is good experience by the way. Make Human supposedly exports skinned and rigged. I tried exporting it every way I could to get it into Unity. The armature was all wrong. I had to export it with no armature, skinning, or rigging. Then create the armature and do the skinning and rigging myself in Blender. Then I was able to import it into Unity where it worked well enough for my purposes to learn game programming. That was the first time I did it. Seems like it might have gotten better at this. The last Make Human character I've got here looks like I may have got it to export skinned and rigged. It might still require going in and renaming all the bones in order to get it to import correctly into Unity's Mechnim though. I know a lot more about all this now, and maybe some of the troubles I had the first time around where just not knowing what I was doing.
This was awhile back, and the software may have improved since then. I was able to find my last Make Human model. She has 28,000 triangles with no hair. I would call that too many. I've got an older graphics card that is about to get replaced with a GTX1080. It can handle between 3 and 4 million triangles before it starts choking in Blender. Considering you have an entire game scene to render, you probably don't want to blow your entire poly budget on one character, even if it's the main character. I think it's fair to say this model is way too high poly for a serious game. To truly be useful, it should probably export a 10,000 or less triangle model with a normal map to make it look like a 1,000,000+ triangle model. But that's not what it does.
I thought there was an option to export a low poly model, but I just opened the program and don't see it. Seems as I recall the low poly model was too low poly. And that's not really what you want. You want a low poly model that looks high poly. That's done through normal maps, which it is not doing.
I'm looking at the topology. There's way too many quads in the toes and ears. But other than that, it's not that bad. I think you could flat out delete the back sides of the eyeballs, although not sure if doing that would mess up the UV map or not.
You could probably box select half of this mesh in Blender and delete it. Then mirror the half you deleted and redo this model in Blender with a pretty good starting base if you wanted to. With a lot of work you could probably go in and remove edge loops where they are not particularly needed. I might remove a loop or two from the foot, But I would probably remove all of them practically from the toes. The toe nails seem to be somewhat modeled as well, which could probably go. I might consider removing every other edge loop in the legs, arms, and torso. Or course, if you start doing this much work, you're going to have to completely regenerate UV maps and repaint the model. The more I look at this, the more I'm about half inclined to actually do it.
And to a certain extent, I think maybe that's kind of the idea behind Make Human: that you use it as a starting point for art projects. I think this model was designed for still picture art as much if not more so than games.