The add was good, but I think stories like this also invite criticism of where whatever company is not doing well.
Many in the blind comunity ar starting to notice the bugs in VoiceOver that go unaddressed sometimes for years. The general consensus seems to be that VO has stagnated on the Mac and people are going back to Windows because there are third-party screen readers that provide users with the know how to improve the usability and efficiency of apps. People are saying that Safari is difficult to use with VoiceOver even on AS machines.
I have only seen a few deal-breaking bugs in iOS myself (and yes, I do sometimes install the PB versions and report bugs to Apple). Back in iOS13 there was a bug where VoiceOver would completely lock up when you hung up a call. The only way to be able to use your phone again would be to force restart, but with no audio feed back I had no way to tell when or if my phone was restarting. Since the force restart sequence is also used for activating emergency services, I had a few unintended 911 calls that I had to explain what happened. The bug didn't get fixed until iOS 13.2. If something similar happened to the everyday user, where your phone screen went black after hanging up a call, you can bet there would've been a 13.0.1 patch released within a week.
The one over all improvement I think needs to happen with accessibility would be that all apps have to meet a baseline accessibility requirement to be in the app store. I get that not every app can be made to work for everyone, but I think things could be improved within reason in many cases. Perhaps app store listings could have badges that say that an app is compatible with VoiceOver, Assistive Touch, etc., much like how apps currently list wallet or family sharing support now.
As for the features shown in the add, I haven't had much luck with them. When trying to use the image description feature, I sometimes get different descriptions even without moving. Same with the door detection feature when playing with it on a 13 Pro at the Apple store. Perhaps I'm just terrible at pointing a camera though. lol