It can be pretty shitty but for my ADHD I get a semi-isolated room (max like 20 people) with dividers and 1.5x time on exams. I know that other accommodations exist but I haven't thought I needed them enough to ask for them so I don't know how accessible they are. This is a public school in the south so things could be better or worse where you are but this has been my experience. While this is nice but it is not perfect. I do have to schedule these exams with the testing center myself a week or two in advance and while this is probably unavoidable for a school of this size it still definitely tripped me up at first.

It should also be noted that I am likely also on the spectrum and the reason I have managed as well as I have, which admittedly isn't stellar, is because I have been able to teach myself most of the subject matter by reading the textbook and doing the homeworks. I rarely attend lectures because I find them uncomfortable and generally not worth it (with exception) but I will meet with the professor occasionally if I get stuck. We all adapt in our own ways, traditional academia is still a hostile environment but its do-able for some