It alters queries, shifts indexes, and forces the database to think differently. The schema you shipped last sprint is no longer the same schema. Production will feel it.
Adding a new column is not trivial. Whether you work with PostgreSQL, MySQL, or a distributed data store, the operation impacts storage, I/O, and application logic. You are defining a new field in the table definition—ALTER TABLE ... ADD COLUMN—and every row will have to account for it. Even when the default value is NULL, there are performance and locking implications.
In PostgreSQL, adding a column with a constant default will rewrite the table, locking writes until completion. For large datasets, that can mean downtime. MySQL handles some cases online, but watch for edge conditions that trigger full table rebuilds. Column order is mostly cosmetic to SQL, but certain ORMs and serialization layers will depend on it, so decide its position with care.