So if you are an AWS user for example and want to be in multiple availability zones the Elixir distribution model will not scale and you'll have to use the same techniques and tools other languages use for distribution.
With that in mind, I think the whole distribution buzzword is way over hyped since the majority of companies will be leveraging cloud platforms like Azure, AWS, Google Cloud, etc.
I write Elixir code daily because it's an awesome language to write in and not for the distribution features.