Probably works fine for complex digital multilayer boards but the constraints of two sided are beyond its capabilities. Also for two sided mixed analog digital boards the autorouting isn't capable of routing. Overall it is a very capable piece of software but probably not the best choice if you are designing a few PCB's per year. Also for example if you wanted a 3 pin right angle header with 3D model you would need CAD software to take say a 10pin header and cut down. microcontrollers) which are not in the database and also not necessarily available from manufacturers and setting up new components correctly along with 3D models takes time and skill.

Also there are many newer components (eg. Allegro and OrCAD products, you must have a valid license file (LICENSE. So safer to copy the components to your own local component library. Altium is traditionally considered a mid range tool with a high end price. Also using their database is partly dependent on having a subscription so you may be cut off from this at any time in the future since they are moving to a cloud based setup.

The cost of a subscription is high so if you don't subscribe and update every few years you may end up with a version which has bugs or only partly implemented new features. Much of this is not useful for a small company and even a hindrance. Also integrating all areas of manufacturing from sourcing components to mechanical integration. Altium Designer is a complex program really intended for large enterprises with many collaborators working on projects.

Altium license cost 2020