This is a pretty common remark when you first get to see the RP2040 specs.
But digging a bit deeper, yes, you can use the PIO and the PWM as timers. (PWM don't have to actually drive any IOs.)
It is unusual certainly, but in practice is not a big limitation. The one "timer" is more intended as a tasking timer of sorts. In many MCU applications, you find yourself using one timer for this kind of stuff (scheduling/timing tasks), and the µs resolution for this is more than adequate, so that makes sense.
If anything, the PIO and PWM blocks may not be numerous enough for some applications, but that's life. Just like the number of GPIOs may not be enough. It's a $1 chip available with only one configuration. If it doesn't fit your needs, use something else.
Also, in some other architectures, you find yourself needing more timers for lack of appropriate peripherals, but with the PIO, you get a lot of flexibility which alleviates the need for a lot of "timers" (as single-purpose peripherals).