The year or so after Musk took over was brutal. The influx of far-right pests, troll farms and porn bots was one thing, but the reliability went down the drain.
Inertia is a hell of a force.
All that he seems to be doing these days at Twitter is messing around with the recommendation algorithm, override the decisions of what's left of moderation for his far-right friends and that's it. Oh and of course Grok/xAI or however it's called these days, but IIRC that's a separate corporate entity that just got shoehorned onto Twitter.