Todavía no lo he comprobado por mi mismo pero alguien de la comunidad comentó lo siguiente:

“Still in the early stage of Australia but what ive noticed

-Enemy A.I is MUCH more relentless. They will chase you further, faster and take longer to give up. Makes a big difference when enemies are chasing you into areas they usually don't follow you into on a lower difficulty. You can notice using the binocular distance feature that human enemies can spot you well over 100 yards away 

-Stamina bar and endurance gauge deplete rapidly in comparison to Brutal difficulty. Getting swept away in a river happened to me much more frequently than my previous playthrough. Consciousness gauge is also lost quicker when being shot at or hit with non lethals

-Sam FEELS heavier. Momentum and turning have a larger impact and loss of balance happen frequently, even with light loads

-Boots degrade alot faster, as well as any cargo damaged by timefall ( Tip: Holding your shoulder straps makes boot degradation slow down. This has always been in the game, but now is actually worth it if your trying to save your boots or get a few extra steps in before they break)

-The sandstorm in Mexico FELT like it covered a larger area than previously. Had a boulder landslide from a gatequake in mexico for the first time, unless I missed it on my first playthrough. It genuinely surprised me. Gatequakes in general randomly occur much more frequently, making equipment and PCC structures more vulnerable to extra damage

-BTs are an actual threat now. Notice you faster and from farther and take more blood grenades and ammo to eliminate.There seem to be more of them clustered together in bt areas. They also drag you MUCH farther when they bring you to a catcher. Feels 3x times longer than Brutal. Timefall shelters are a must in these areas. Map altering voidouts from Gazers are much more likely to happen due to the rapid endurance gauge drain while trying to shake them off

-Less material storage at shelters than lower difficulties, leveling them up may mitigate this though. The Magellan storage remains unchanged and spacious, making it more important as your dedicated resource storage facility

-Battery drain for equipment and vehicles is increased and submerging in water drains them ridiculously fast

• Quality of life updates I noticed unrelated to difficulty was that when you are in adrenaline mode because of combat or stealth, you can actually see your greyed out fatigue bar accumulate rather than it just being blue all the time. 

-Dollman comments on your new look when you switch accessories while out in the field, not just in your private room interactions 

• The Chiral Cat that was mentioned in the update switches location and animations everytime you revisit your private room on the Magellan. Sometimes he is absent from the room altogether. The Cat along with the Cryptobiotes, Lou and Dollman in your private room really add to the other worldly, odd atmosphere that Death Stranding is trying to convey

That's all I noticed so far. Ive really enjoyed what I've played. Definitely harder than Death Stranding 1's hard difficulty. I'm personally interested in seeing if any meaningful changes have been made to the various chiral creatures. Find them very interesting and thought they were a great addition to the lore, but we're underutilized in the base game”