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Where would you want difficulty to come from then? If it's not "you gonna die real quick if you mess up" then what?
You want the short or the long answer? Ah what the heck I'm feeling generous, I'll give both.
Short: stacked status effects and coordination difficulties. One-shots are the poor man's idea of balance, it comes from bad MMO diet. Really unfortunate stuff.
Long: I'll just give you an example whipped up from my day to day FFXI experience. This is the basics.
We go into a dungeon and engage some random goblin suitable for our level. Midway through the fight, the healer ends up taking a few hits because the tank lost hate temporarily (he was trying to heal and thus couldn't use Stun in time and the opponent got off a big move and thus lowered their hate toward the tank you see). What this means is a number of things:
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It means that skeleton a room back is now coming with an army (undeads have blood aggro so they attack people at low hp and can 'smell' them from a distance)
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It means the bard might need to AoE sleep a bunch of unintentional aggro and we need to coordinate and decides who fights what, because attacking a slept mob wakes them up which is sometimes a recepy for a TPK
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It means your skillchain might need to change to something completely different mid fight (whoever ends the skillchain gets the hate generated by the skillchain), which essentially means our entire party needs to reconfigure their scheme mid combat
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It means the healer might need to change who gets haste (putting haste on the tank instead of the DPS) or delay removing the status on someone
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It means I might need to consider whether I have to Cure Waltz now or can still save TP (TP is a gauge you build up as you attack) for my weaponskill
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It means I need to consider if to switch from Aspir Samba (party wide MP regen on hit) so Drain Samba (party wide HP regen on hit)
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It means I might need to consider blowing my own Chakra (big self heal on big cooldown) early instead of using it to remove blind/paralysis because being at full health removes some of the burden of the healer and it means they take less hate for a bit due to healing, so things can stabilize
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It means that suddenly I blew a bunch of my stored TP on healing and status removals, which puts me out of sync with the TP generation of the party member I was supposed to skillchain with, thus throwing a wrench both in our DPS
and
our ability to keep hate stably on the tank.
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During this entire time, our Dark Knight needs to mentally keep track of the opponent's TP (which is invisible) despite the fact that our attack pacing changed and thus the speed or their TP generation. This is because the Dark Knight can drain TP and thus delay enemy weaponskills. It keeps us alive.
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The Dark Knight and Paladin both have stuns to stop big enemy attacks and they need to coordinate their own timings so they don't both do it at once, but alternate.
We manage to win and breathe easily for a bit. No, I'm just kidding, it's time for the next monster. This time we select a Crab because our WHM is low on MP and if I use Aspir Samba on such a tanky mob with MP, our White Mage can regain MP in time for the next fight. We obviously have to keep in mind respawn timers on those goblins we fought earlier. If we mess up, they will respawn and aggro on us and kill all of us. And we need to make sure not to blow all of our TP on the crab, we need it for the goblins.
There's many other examples, and many types of fights and tactics, but I wanted to keep it simple for now.