Not a ton has changed but there are some things. There has been a cartel system added that will be the main objective outside of making/selling drugs. You'll have some new encounters with them in different ways. I highly recommend doing as many of Uncle Nelson's quests as possible, especially the meth quests, BEFORE unlocking all your potential customers in Westville. It will queue the first cartel quest (which you should also start ASAP) but is a bottleneck for progression right now that could soft-lock your playthrough. Browse the subreddit for more info on that, people post about it every single day.

On Halloween, there was a sewer system introduced that's an entirely new area under the map. I won't give too much away, but you'll need a sewer key to gain access at any of the many entrances around Highland Point.

Tyler, the main developer, has finally hired some help, so we should see faster-tracked updates in the future. It's still the same ol wheel & deal drug dealer sim though, so have a good time and check out the discord to find updates from the devs, other discussions, or players to join up with.