There are of course ways to construct difficult problems in high-dimensional manifold theory. One of the ways high-dimensional manifold theory differs strongly from low-dimensional manifold theory is in the study of automorphism groups, like the diffeomorphism group of a manifold. In this case, dimensions $n \leq 3$ is very well understood, but dimensions $n \geq 4$ are considerably more difficult, and in many respects dimension $4$ more closely resembles high-dimensions than low dimensions, as far as we can tell at the moment.
But your question is specifically about what the term low-dimensional topology means. And this is tied to the story of the classification of manifolds, and the tools we developed for the task, like the Whitney trick and h-cobordism.
Here is maybe an analogy to help understand how h-cobordism makes life easier in high dimensions. If you are studying a rock pile and someone asks you to classify all the granite rocks in the pile. If you didn't know any better you would have to pick through all the rocks and investigate them one by one. Maybe you'd have to split some rocks if you were suspicious granite was fused into the centre of another rock. But if you have a magical rock sifter that could pick out all the granite for you, it would be quick and easy. h-cobordism is something like that magical rock sifter as it allows you to readily identify all the manifolds that satisfy certain homotopy properties. I like to think of it as something that makes the subject more uniform and homogenous -- it allows you to quickly find the things you are looking for. Low-dimensional topology is less uniform so you have a harder time finding out if certain types of manifolds exist. Like, say, a counter-example to the generalized Poincare conjecture.