Not sure why this is in the fusioncash section, but to answer your question.
Yes I use coupons, even ones printed out online. But only at Walmart.
Walmart will also do ad comparisons, so lets say you see your favorite body wash on sale at a different store in the sunday ads, you bring the ad (although they don't require the ad, sometimes it's helpful if its a large discount so there's no arguing), and any coupon you might have for the item and you tell the cashier you're going to ad comp that item.
My sister also does this, with her toddler and husband she was normally spending $200 a week on groceries/household items, but now she's spending half that and still getting the same amount.
Extreme Couponing show is a bit misleading because they usually only show people going specifically for a bulk amount of one or two items and saving a ton of money on them. But they usually don't show them doing their normal grocery shopping with meats and fruits and stuff.
There are alot of tips online about couponing, one is to contact the manufacturers directly and ask about receiving coupons, especially if you're wanting to try healthier/organic foods, just let them know "i'm wanting to eat healthier and was wondering if I could receive some coupons to try out your products". Other manufacturers have coupons already available on their website or ask you to subscribe to their newsletter to receive them. Some manufacturers don't mention this but if you give them feedback on products you've used, they'll send you coupons in the mail.
Other stores have more restrictions now, even walmart has restrictions. It's best to call the stores ahead of time and find out what their policy is on coupons/ad-matching before you plan your grocery trip. But it's definitely worth it, can end up saving alot and still getting what you need.