We spawn with joke weapons, we can't access or hack medvendors anymore, we get rushed by runners at five minutes into the round, we fight mature Tier 3s and ancient Tier 1s fifteen minutes into a round, LV is toxic, and we still often spawn with no shoes.
Spoiler:
I enjoy playing survivor for the challenge, but the evo/maturation update combined with all the other pre-existing and new issues makes actually surviving as a survivor feel like beating Dark Souls on a Deprived, no-pickups runs while using a Guitar Hero controller.