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It's purely for player preference on how difficult one desires the game to be.
Enemy Armor, Health, and Damage will increase by difficulty. The only other noteworthy challenge is that NG+ (on any difficulty) allows access to Tarroch's Tomb in the Ossean Wastes of Act-2 after finding 3 Golem Souls and placing them into a bowl randomly located in the desert. It offers a one room dungeon fighting waves of foes from dungeon level 101 to 199.
The easiest way to gather any item is to be within 15 Dungeon Levels below or above the desired item's level then farm Phase Beast Maps: complete the map challenge, don't leave the map, save / quit, return to game, Phase Map will be ready to farm again.
In my view:
Casual is too easy.
Normal is good to avoid getting one-shot-killed.
Veteran can one-shot towards the end-game.
Elite one-shots from the beginning of the game hence needs damage-taken-reduction farming early on or staying at range or separating crowds.
Increasing the amount of health your character has and also equipping HP and MP regeneration gems or items is also very helpful.
We usually recommend Veteran for experienced RPG players, and Hardcore is not recommended for your first character on the game, as there are many tricks and traps you will encounter. The amount and difficulty of those tricky episodes will also vary on subsequent playthroughs with new characters, as the map configurations can change.