There absolutely will be problems with different Nix profiles that aren't updated together; for example, if you update some packages installed in your user's profile but not the running system profile. But this is common enough with other glibc ABI breakage that folks tend to update home and system profiles together, or know that they need to reboot.

Where it will be hell is running Nix-built packages on a non-NixOS system with non-ABI-compatible glibc. That is something that desperately needs fixing on the glibc side, mostly from the design of nss and networking, that prevent linking against glibc statically.