I could almost get away with using one patch, but I don't try, because I don't have to.
All of my patches use six scenes (the names are how my MFC-101 is labelled):
1. Mild (cleanest)
2. Medium (in-between)
3. Spicy (crunchiest)
4. Dry Mod (usually the "Mild" amp with chorus or vibe, and short delays at most)
5. Wet Mod (general clean and expansive or ethereal)
6. Lead (usually the "Spicy" amp with lead-appropriate compression, delay and reverb)
My MFC is set for one preset per bank. The bottom row are the first five scenes, and the Lead switch (Scene 6) is up at the top, next to the tuner switch. The other switches are all individual effect switches (Comp, Drive, Phaser/Vibe, Filter, Chorus, Tremelo, Wah, Pitch, Delay and Reverb). I started doing that because I used to have a Digitech RP-100, which offered a "pedal board" mode, where you were essentially switching between pedalboards. I'm thinking of changing this, though, since I rarely find myself stepping on the individual on/off switches any more.
I have eight (or, more realistically, four, since they're really just single-coil-voiced and humbucker-voiced versions of the same four) "Workhorse" patches that cover a general, wide range of sounds I can use on almost everything. The main difference between them is in the amps I use as starting points. Though the Fractal is much more consistent night-to-night and room-to-room than my old tube amps were, I play with lots of different groups, and sometimes a Voxy sound sits in the mix better than a Marshally sound. Also, some amps work better in certain rooms. For example, I'm less likely to choose the workhorse patches with the Captain Hook or Mesa amps in a room that's prone to boominess.
But I don't just use the Workhorse patches, though I do follow the same scene structure in most of the patches I use. I have a version of it that I pull out for country tunes, where every scene is clean and more compressed (the spicy version has a bit of grit and a slapback), as well as an 80s version which only cleans up for scene 4 (the Dry Mod, JC120 chorus sound).
I've also got a few song-specific patches ("Hotel California", "Owner of a Lonely Heart") and a few artist-specific patches (Bono, Gilmour, Andy Summers) that break the six-scene-schema somewhat.