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Some of those people might be able to walk for short periods of time. From the handicap spot, its at most 2 minutes to the cart. Maybe after 5 minutes of walking, they could be anogonizing pain. So they ride around do shopping and just have to suffer through a short walk to/from the cart.
If they completely can't walk, I guess they have to get someone to bring them the cart. Depending on the disability, you may still be able to drive, but not walk. Could be modified controls for the car or something.
Maybe you can move your legs just fine but standing on them is a problem (it's hard to push a cart and use a cane or walker)
Maybe they can walk just fine, but can't push the weight of a full cart, so they ride.
And finally, there just the lazy ones that don't really need them.