Make "is a tool which controls the generation of executables and other non-source files of a program from the program's source files. Make gets its knowledge of how to build your program from a file called the makefile, which lists each of the non-source files and how to compute it from other files. When you write a program, you should write a makefile for it, so that it is possible to use Make to build and install the program." (from http://www.gnu.org/software/make/).
Make is primarily used when compiling software natively on the slug. If you're not compiling on the slug, you probably don't need it. It is possible, of course, to do lots of things that aren't compiler related in make, and you might want it for those things too.
M4, make and patch should be made a part of the same package at some point.