It wasn't that long ago in my career when a survey showed the vast majority of SQL Server databases were < 10GB in size. These days I'm sure the average has risen as there are some very, very large SQL Server databases. I know a few people managing PB sized systems, which certainly will move the average upa bit. It's likely, however, that the majority of databases are still very small, powering smaller applications with < 100GB.
However almost every databases continues to grow, and as systems grow, new challenges come into play. While we can still store a 100GB backup file on a thumb drive or SD card, it's still a significant amount of data to write, which can take more time than our clients would like. Archivals, backups, restore, all tend to come from non-flash media, so larger systems certainly mean longer RTOs if we have issues, even if we're just restoring a copy of a database to extract some deleted information.
However there can be more fundamental problems. I ran across a post from the CSS Engineers at Microsoft that talks about exhausting NTFS resources as more and more writes occur on a filesystem. I'd never heard of this, or expected it to be an issue, but apparently it's occurring more often. I suspect even the NTFS developers hadn't considered the scales to which we probably stress the file system daily. What is interesting is that this can occur with DBCC operations, database snapshots, and even bcp operations. There are workarounds, and certainly I'm sure that Microsoft has people working hard to increase the capacities of ReFS, which I expect will take over from NTFS, just as NTFS has largely displaced FAT.
As we grow to larger and larger scales of data sizes, with multi-terabytes on laptops and petabytes on servers, I think we'll need to adapt a number of our techniques and operations in the future. We might end up needing different types of backups (anyone considering lookup table backups or daily backups of a set of rows, like orders?), as well as the possibility of continuing to spread the load of our server across multiple drives. I just hope that Microsoft recognizes this and looks to ensure mount points work smoothly across all of their technologies and features. At some point, 26 drive letters won't be enough for the majority of us.