Quality of Service (QoS) is a rather broad topic in general. For MQTT though, QoS takes a simple form. It allows an application (= a client publishing or subscribing to a topic) to choose one of the following transport guarantees:
A client won't receive any confirmation from the broker upon receipt. Likewise a message delivered to a client from the broker is not required to be acknowledged. This is the fastest way to publish and receive messages, but also the one where message loss is most likely to happen.
A client will receive a confirmation message from the broker upon receipt. If the expected confirmation is not received within a certain time frame, the client has to retry the message. A message received by a consumer must be acknowledged on time as well, otherwise the broker will re-deliver the message.
The first part of the QoS 2 flow is similar to QoS 1. A second flow ensures that sender and receiver (broker) agree on where the message stands. The point is to avoid duplicate routing, i.e. delivery to the subscribers downstream of the broker, as the broker can recognize duplicates itself. QoS 2 doesn't necessarily imply that the publisher will only send the message once, it will still retry if it gets no acks from the broker.
The choice of QoS should be based on the network environment. A mobile app could use QoS 0 whenever it is connected to a reliable wireless connection and falling back to QoS 1 when connected to the mobile network.