I have yet to have any issues with it and I switched full time to LTSC on multiple devices for about 2 years now, the only minor trade off is if something you rely on is not installed automatically like the Microsoft store.
So when you first launch the Xbox app it will tell you that there are things that need to be installed, but it gives a button to do exactly that.
You also don't get new features that Microsoft roles out, but I don't consider that a trade off and is instead a positive. Bonus I was able to un-install copilot completely from control panel on Windows 11 LTSC.
