They are very effective...but it depends on the end user.
Purely from a theoretical perspective, bioballs are an outstanding high flow, large surface area media that allows to excellent oxygenation and growth of bacteria that break down ammonia and nitrite.
Second only, IMO, to live rock or live sand - because both of the have an added benefit to the natural ecosystem concept.
Bioballs may not be necessary in a system which has adequate lr, ls and is not overstocked. However in large predator systems they are, IMO, mandatory and can save a lot of systems from a crash. They are, hands down, the best insurance policy.
Most people who say they are "nitrate factories" are, to be honest, a bit premature in their dislike and probably, to some degree, uninformed and taking the party line.
The KEEPER of the tank causes nitrate problems. That is the start and the end. Overstocking, overfeeding, lack of maintenance and export...cause nitrate problems.
Bioballs are fantastic but like anything it ASSUMES a certain amount of responsibility in using them. Any filter is going to kick your butt at some point if you are overfeeding, etc. I nearly lost my tank to a crash because I just stopped maintaining it and fed like crazy. Stupid me. But it wasn't my filter that did that. It was my filter that probably allowed me to get by so long. It was an insurance policy...my filter includes LR and a tidepool (effectively huge biowheel).
They are not hard to keep clean. This hobby actually takes a bit of effort. But they are certainly not hard to keep clean if you actually start your maintenance regime on the feeding and stocking side.
all, JMO