The worst thing is, the one of the two "choices" sometimes just impacts the line Shepard says (and the requisite Paragon/Renegade points, of course). I'm doing a Paragon run-through with my Shepard that goes way back to ME1 and I watched my brother play the start of the game as a Renegade. When he chose a different dialog response, literally the only thing that changed was what Shepard's line was.
That's not choice. That's even less consequence for your choices than an Choose Your Own Adventure-book. But that's limited to dialogue, I do love how some of your choices from previous games are surfaced in the overall narrative.