Every once  in a blue moon  it actually matters that some mathematical entity which might  *a priori* only be a class is in  fact  a set. For  clarification,  here are some examples of what I  do  **not** mean:  

A) Some colleagues of mine once  made the following disclaimer:  'The "set" of stable curves does not exist, but we leave this set theoretic difficulty to the reader.' These colleagues (names withheld to  protect the  innocent) are  of course  fully  aware of  the fact that strictly  speaking, the class of all  stable  curves, or topological  spaces, or  groups, or any the other usual suspects customarily formalized  in  terms of structured sets, cannot itself be  a set. While they recognize that  the  structure they study is transportable along arbitrary bijections between members of a proper class of equinumerous sets, they also recognize that in their setting this  same transportability could justify a  technically sufficient *a  priori* restriction to some fixed  but otherwise  arbitrary  underlying  set: that is, the relevant large category has a small skeletal  subcategory. (Exercise: precisely what makes this work  in the example given?) In such cases, the set versus class pecadillo is an essentially victimless  one, perhaps barring discussions  of the   admissibility of Choice, expecially  Global  Choice. 

B) There are various contexts in which seemingly unavoidable size issues are managed through the device of Grothendieck Universes. Such a move  beyond ZFC might  be regarded as cheating, sweeping the issue under the carpet for all the right reasons. Allegations of this nature regarding the use of derived functor cohomology in number theory, as in the proof  of Fermat's  Last Theorem, can  now be laid to rest, as Colin  McLarty has nicely  shown in "A finite order arithmetic foundation for cohomology" http://arxiv.org/abs/1102.1773.

C) Set  theory itself  is  replete with situations  where the set  versus class distinction is of paramount importance.  For just  one  example, my very  limited understanding  is  that forcing over  a  proper class of conditions is not  for the unwary. I'd be  interested to  hear some expert  elucidation of that, but my question  here is in  a  different spirit.   

With these nonexamples out of the way, I have a very short list of examples that do meet my criteria.  

1)  Freyd's theorem on the nonconcretizability of the homotopy category in "Homotopy  is  not concrete"  http://www.tac.mta.ca/tac/reprints/articles/6/tr6abs.html. By definition, a *concretization* of a  category is a faithful functor to the category of sets. The homotopy  category (of based  topological spaces) admits  no such functor.
The crux  of the  argument  is that  while  any object of a concretizable category has only a set's worth of generalized normal subobjects, there are objects  in the homotopy category - for example $S^2$ - which do not have this property (page  9). The original  closing remark (page 6)  mentions another nonconcretizability result, for the category of small categories and  natural equivalence classes of functors. A purist might try to disqualify the latter as too `metamathematical', but the homotopy example seems unassailable. 

2) A  category in  which all  (co)limits exist  is said to be *(co)complete*; a *bicomplete* category is one  which is both complete  and  cocomplete. Freyd's General Adjoint  Functor  Theorem gives necessary  and  sufficient conditions for the existence of adjoints  to  a  functor $\Phi:{\mathfrak A}\rightarrow{\mathfrak B}$ with $\mathfrak  A$ (co)complete. Let us say that  a  functor which  preserves all limits  is *continuous*, and that  one which preserves all colimits is *cocontinuous*.  A *bicontinuous* functor is one which is  both continuous and  cocontinuous.

Let us say that  $\Phi$ is  *locally bounded*  if for every $B\in  {\rm  Ob}\,{\mathfrak  B}$ there  exists a set $\Sigma$ such that for every $A\in{\rm Ob} \,{\mathfrak A}$ and  $b\in{\rm Hom}_{\mathfrak B}(B,\Phi A)$ there exist $\hat{A}\in{\rm Ob}\,{\mathfrak A}$ and $\hat{b}\in{\rm Hom}_{\mathfrak  B}(B,\Phi\hat{A})\cap\Sigma$ such that  
$b=(\Phi \alpha)\hat{b}$ for some   $\alpha\in{\rm Hom}$ $_{\mathfrak A}$ $(\hat{A},A)$, and that $\Phi$  is  *locally cobounded*  if for every $B\in  {\rm  Ob}\,{\mathfrak  B}$ there  exists a set $\Sigma$ such that for every $A\in{\rm Ob}\,{\mathfrak A}$ and $b\in{\rm Hom}_{\mathfrak B}(\Phi A,B)$ there exist $\hat{A}\in{\rm Ob}\,{\mathfrak A}$ and $\hat{b}\in{\rm Hom}_{\mathfrak  B}(\Phi\hat{A},B)\cap\Sigma$ such that  $b=\hat{b}(\Phi \alpha)$ for some   $\alpha\in{\rm Hom}_{\mathfrak A}(A,\hat{A})$. In the literature these are known as the Solution Set Conditions.  
  
**Theorem.**
Let $\Phi:{\mathfrak   A}\rightarrow{\mathfrak B}$ be a  functor, where $\mathfrak  B$ is locally small.  

$\star$ If $\mathfrak A$ is complete then $ \Phi$ admits a left adjoint if and  only if  $\Phi$ is continuous and locally bounded.  
$\star$ If $\mathfrak  A$ is cocomplete then $ \Phi$ admits a right adjoint if and  only if  $\Phi$ is cocontinuous and locally  cobounded.  

See pages  120-123 of MacLane's "Categories for the working mathematician". The local  (co)boundedness condition has actual content. For  example:  

a) The  forgetful functor  ${\bf  CompleteBooleanAlgebra}\rightarrow{\bf Set}$ is continuous  but  admits  no left adjoint.  

b) Functors ${\bf Group}\rightarrow {\bf Set}$, continuous but  admitting no left  adjoint,  may be obtained as  follows: let $\Gamma_\alpha$   be a simple  group  of cardinality $\aleph_\alpha$ (*e.g.* the alternating group on a set of that cardinality,  or the projective special  linear group on a  2-dimensional vector space  over a field of that cardinality) and  take the   product (suitably construed), over  the  proper class  of all  ordinals, of the  functors  ${\rm  Hom}(\Gamma_\alpha,-)$.  

c) Freyd proposed another interesting example  (see page  -15 of the Foreword  to   "Abelian  categories" http://www.tac.mta.ca/tac/reprints/articles/3/tr3abs.html) of  a locally small bicomplete  category $\mathfrak S$ and a bicontinuous functor $\Phi:{\mathfrak S}\rightarrow {\bf Set}$ which  admits neither  adjoint: loosely speaking, the  category of  sets equipped with free  group  actions, and the evident underlying set functor. 
 
Does anyone know of any other examples, especially  fundamentally  different  examples?  

Finally, one could focus critical attention on the very question posed. To  what extent does the strength  and  flavor of the background  set theory  matter? Force  of habit and  comfort have me  implicitly working in some material set theory such as ZF, perhaps a bit more if I want to take  advantage of Choice, perhaps a bit less if I prefer to eschew Replacement. Indeed, I have actually checked that example b)  may be formulated in the absence of  Replacement: while the von  Neumann ordinals are no longer  available, the  same trick already used to give a kosher workaround to the illegitimate product  over all ordinals further shows that an appropriate system  of local ordinals suffices for the task. I am also quite interested in  hearing what proponents  of  structural  set theory have  to say.