Last write wins. There are several features for controlling consistency that we have been prototyping. Based on how storage is used we will enable those as the product matures.
Currently this isn't a great way to serve content because the values are limited to 64k, you have to infer content-type (which makes your URLs ugly), etc. So I don't recommend it. We'll come up with something better in the future. :)
One great example of why this would matter to me - could workers ever institute a coordinated rate limiting function using this KV store?
By combining those with KV to do global coordination on a more course time scale, I think you could.