The reality is that if you are creating a library you probably should prefix your types and functions anyway. And rely on the prefix to minimize collision probability. So it doesn't really matter if you put _t and the end of your type aliases. You will probably not get the collisions anyway. Unless POSIX is going to suddenly introduce mylib_array_t or something.
No, but your compiler MIGHT decide in a future release that it's a whole lot faster to ignore the header files for standards types and definitions and just copy a pre parsed version of the struct into the symbol table when the header is included. It might look at the _t and decide nope, I don't have a definition for this so it's an error, despite your own definitions.
This probably won't happen. But if it does you don't have any grounds for complaint really.
The compiler to do that would also need to drop C standard compatibility (section 7.1.3 of C99). Which is probably a good reason to complain and to just stop using that version of this purely theoretical compiler.
I wish people would stop perpetuating this particular naming convention. Its in violation of POSIX which specifically reserves the entire *_t ‘namespace’. Obviously its fine if this is done on a system or environment for which this is irrelevant, but its best avoided otherwise.