Pgroll offers a method to implement zero-downtime schema changes in PostgreSQL, appealing to teams managing slow rollouts. However, it faces skepticism regarding its complexity and potential reliability issues. Users express concerns about the intricate internal processes compared to traditional methods, where a .sql file is used, making it easier to understand and revert if necessary. The discussion highlights the need for better integrations with existing tools like Prisma and other migration solutions like Sqitch. Users acknowledge that while Pgroll introduces certain conveniences, its reliance on complex behind-the-scenes operations may lead to significant challenges, particularly in a live environment.