It's sorta like the network neutrality argument, except you're talking about limits on who can offer services to everyone vs those with newer IPv6 devices and ISPs. You can end up with two different Internets.
Everything we've done assumes an IPv6 network - trying to squish large device networks into IPv4 is just a losing battle for a huge number of reasons (address mobility, address conflict, large number of downstream devices (20,000+) per network segment, etc...)
Medical devices of some kind? Just guessing.
Both of them lend themselves well to mesh networking application, and mesh networks, in which any one of the 5mm+ deployed devices might appear in any one of the 10,000+ network segments, and in which we just want to concatenate the MAC address and Network segment to get a network address (basically SLAAC) - really makes IPv6 a pretty good fit.
If the app backend is not also available from a network where IPv4 is completely blocked, the app is rejected.
At the same time, AWS does not let new accounts to create EC2 instances outside of VPC, and only provided IPv6 support in the non-VPC classic stack (only available to old AWS accounts that signed up years ago).
So for the last few months, AWS has been unusable as a backend for iOS apps unless you have an old classic AWS account.
I don't think your description of Apple's requirement is accurate.
https://developer.apple.com/library/content/documentation/Ne...
In addition, I think you overestimate the difficulty of conversion. Most backend servers run on 10.x.x.x networks and that doesn't need to change. You just need a proxy in front of them that can speak IPv6. Installing a new proxy does not sound like a hard job. It sounds trivial.
If I'm running a small startup that's available as a website, how does IPv6 support matter to me? (Assuming that I can otherwise get IPv4 addresses for hosting my site, which I can.)