I update my install every month without fail. I do back up the VM machine and ensure HA backups are made before install but I've only had one issue in five odd years of using HA (my Hive valves and thermostat). Always read the change log first before updating though in case there are breaking changes that affect you
As b0rn2sk8 said though, it's certainly not completely maintenance free and does require someone to keep an eye on things.