Has anyone noticed any inaccuracies compared to the region your familiar with?   I flew around my neighborhood (Zürich City Limits CH)  which has 2 distinguishable residence towers of about 20 stories, and in the sim they are 1 story houses.   Yet in bing maps the towers are there.   So either my update has an error or the data is not fully encompassed. It seems building height data is hit and miss with some other areas that are seemingly rather low height. 

Occurs about everywhere.

Building height is mostly derived from OSM data and the tagging is sketchy at best, because that data has little meaning for the average OSM contributor.  X-Plane users have probably brought the biggest wash of height tag updates (you're welcome, FS users) in the past few years but the few enthusiasts who do that are not everywhere and tend to do that in their neck of the woods only, because it's a lot of work.  If Blackshark is maintaining and reprocessing their data on a regular basis (?) you can edit the buildings yourself and wait for the scenery to change at some point.

Yes.  In the UK, one of the most visible features for many VFR pilots are the old coal-fired power station cooling towers.  They can be seen tens of miles away and are a great double check of position. Many of the plants are now decomissioned and in some cases the towers have been taken down, but many/most are still there.  But none are visible in the MSFS view. 

It's one of the very few reality killers flying round familiar landscapes in VR with the sim.  Oh, that and the major rivers torrenting down the mainstreets of my home town (which in real life are tiny brooks that many locals don't even know are there) 😉

Still a great VR experience, though...