My kids usually took because they didn't like the choices and also because they had so little time to eat, they preferred to spend it seated chatting with their friends instead of in line waiting to be served. I would have been just as happy to pay the cost and not mess with them and them have a hot lunch, but they preferred not to.
At our HS they had a food court type setup where you could get food from various stations. It was individually priced too. DD still always took because of the wanting to chat with her friends thing. But DS started off his freshman year buying. Finally I figured out that he was getting nachos (but although he PAID for nachos, he didn't get the cheese, just cheap nacho chips), and something like pizza and some non healthy drink and costing a fortune!!! I did tell him he couldn't buy anymore because I wasn't spending a small fortune for him to eat nothing but junk. So he took the rest of HS too. So while I'm sure there were healthy options they COULD get, most of the kids picked the junk options.