I'm pretty much immutable across the board on all of my servers and workstations (laptop included). Most my servers are openSUSE Leap Micro and MicroOS. Run MicroOS on the desktop side as well.
Honestly ....haven't had any issues and the maintenance of it is fairly hands off. Few of mine are k8s nodes so that combined with the reboot mgr + transactional-update has been awesome. I spend less time maintaining my homelabs / desktops and eases my focus in just getting work done.
I've only had to roll back a couple of times (mainly self-inflicted), so it's nice having that capability. A lot of this though can be accomplished in a non-immutable world as well.
Oh man, as someone in Cincinnati I feel targeted. There are worse states? West Virginia?