Never thought about any of this.
So the three things that could happen if I don't use grease are noise, worn coupler, trailer unscrewed the ball.
Noise. I never noticed any particular noise. A loud squeek would definitely get my attention.
Wear. All the balls I use have a flat top so there is no concentrated wear point. The whole ball would have to wear through the coupler. That is not very likely. I have searched the internet anyway. There are some folks that see this as a possible problem but nobody that I could find actually had that problem. I have about 10k miles on my current dump trailer, no signs of wear on the inside of the coupler. Yes I got down on the ground and looked at it with a flashlight and ran my finger around to feel for wear.
Unscrew the ball. If a ball comes loose, I would look to improper tightening, or a cheap ball that deformed. There are more likely explanations than "my trailer unscrewed the ball". Anyway how could anyone know that it was the trailer unscrewing the ball. No way to show that. In decades of towing, including back and forth from VA to CA, all over the place for kids in school, and more or less constant with the dump trailer, I have never had a ball come loose. Of course I use top quality high rated balls and I get them plenty tight.
I was thinking maybe I should start using some grease anyway, it is easy enough to do. Why not? But then I thought, it would immediately get contaminated with road grit and be more like grinding compound than grease. So I would have to clean the coupler and the ball pretty often. For a doubtful benefit.
So I guess I will keep on doing nothing.