Yeah once it hits, it really explains so much of the issues in large organizations (and explains a lot about small organizations / indie development as well). For example, why is it that mergers and buyouts rarely work out? Conway's law largely explains it! When a product is bought by an organization, the result is an integration over time of both organization org-charts combined. If the companies are both large, this immediately becomes an intractable mess. If the original company was small and the new company is large, it _also_ becomes intractable because now different teams will have to communicate to manage or split components that don't fit the communication patterns of the new organization, and will lead to large refactors and rewrites and in the end the essential qualities of the original software will inevitably change.
Even if you know this, there is nothing you can do - you have to organize yourself somehow and how you do that can't be left up to just mirror whatever this piece of software that was brought in happens to be organized - because _that too_ doesn't reflect an actual org chart but is an integration over time of all org charts that have touched it.
I don't even know how to think about the implications this has for the use of open source software and how open source is developed, like... I think there are huge opportunities for research into Conway's law and how it relates to software development practices, software quality, etc.