Distributed session management is essential for scaling ASP.NET Core applications, especially when using sticky sessions. Using Couchbase to store session state can help alleviate these issues by providing a flexible and scalable solution. The Couchbase.Extensions.Session library provides a simple way to integrate distributed session management into ASP.NET Core applications. By configuring the session provider with AddCouchbaseSession, developers can access their session data through HttpContext.Session, allowing them to write and read values from the distributed cache. With this extension, developers can take advantage of Couchbase's memory-first architecture and flexible scaling capabilities to build more scalable web applications.