I've been playing a lot of Hades recently, and like a lot of Roguelites it forces the player to balance between short term gain for the given run and longer term upgrades that make you more powerful for future runs. This takes different forms in different games. Sometimes, like in Hades, it's as simple as choosing between two different rewards, one of which will let you buy long term upgrades and one that's a power up for the current run. In other games it can take the form of optional challenges that might damage or kill you in the current run but provide rewards that will make you more powerful in the future (Hades has these too.) In other, purer Roguelites, it might be in the form of expensive short cuts that take a lot of resources from your current run but help you out for the future by letting you skip areas.
Personally I almost always focus on the long term advantage. I love the feeling of powering up my character in the long term, and since I'm not the world's best gamer it makes the game more enjoyable when I've got a stronger character to start each run out with and the difficulty curve comes down a bit. I usually stand a better chance of getting to the end if I start out with advantages than just picking the best stuff for any given run and hoping my skills will take me all the way.
The only exceptions to this tend to be if a short term item is super powerful, if I'm already on a run with a broken set of items of powers and I think I stand a real chance of beating a boss I've never beat or getting further than I ever have before, or if I'm already on to the end game and I think I might beat the boss on any given run. Otherwise I'm all about gathering as much stuff as I can for long term upgrades rather than focusing on the current run at hand.
How do other people approach this? Are you more balanced? More focused on a given run than worried about long term power upgrades? One slight paradox here is that a short term focus can actually be better for long term power if it takes you further into the game, or makes late game challenges with big rewards much easier, so it's arguably better to focus on powering up on a given run than gathering as much as you can for the long term, but I can't help myself. If I see that permanent currency or long term upgrade out there I gotsta have it!