People I mention this to assume the toughest challenge is variety but as I love to cook it wasn't too hard to make it interesting each day. The toughest challenge was convenience, you grab a coffee or a lunch with friends and there's very few places that cater for all. The second most challenging aspect was cooking meals for the family, as I am the main cook for my wife and kids who did not at all buy into a vegetarian diet let alone keto, but that again wasn't too bad since I could just cook a normal meal, scrape out the bits I can have and whip something up for me afterwards.
After about a year on that diet I ran a sub-1hr 12km charity race which isn't exactly a world record, but not bad for a 40-something always-recovering alcoholic with weight and mental health problems. I'd definitely recommend keto (with proper medical supervision) but... maybe not at the same time as trying to eat less meat.
I've since transitioned to low-carb rather than proper keto, but the increase in keto foods (things made with healthy fats, allulose rather than table sugar, etc.) has made it much easier to do proper keto.
As parent said: YMMV, and we all have different bodies, needs, etc.