A microSD card as is, will have a FAT32 or exFAT file system, allowing it be used as a transfer media to other devices running different operating systems. You can always just leave it in your mobile device and just use it as added storage media, or you can add/remove it to transfer files back and forth to different devices.
But when you format a card as internal (a.k.a adoptable) the file system is changed from FAT to ext4, the same file system as what the internal storage of your phone is set up as. It's also encrypted, with the encryption key tying the card to your mobile device. At that point, that card is essentially a part of your phone, the internal storage and card storage are considered to be one by the Android OS running on your phone. You know longer interact with that card, you can't specifically copy just certain files to it, it's all now managed by your phone.
If you remove the card without going through the process of reformatting it back to external, your phone will be running in an unstable state as you've intentionally taken a part of its storage away. Also, because of that encryption, that card can't be used with any other device anyway. If you put it in a PC for instance, it cannot mount the card because the encryption prevents that. You can however go through the reformatting process back to external, that'll return it back to a FAT file system, and nullify the encryption so the card can be used as a compatible transfer media again.
But to answer your question, yes it does make a big difference.