That depends on the region and age of the road. In more rural areas where the freeways are newer things are much more consistent and usually just as you'd expect. In older areas like New York or California where many of the freeways predate the Federal Interstate system, and where lane expansions, lane extensions, and exits have grown far more organically, there are inconsistent designs (although often consistent within the time period) and even bizarre, one-off stuff.

California didn't even adhere to Federal Interstate guidelines for exit numbering until relatively recently (sometime in the early to mid 2000s, IIRC), decades after most other states. California's scheme predated the Federal Interstate system and they weren't keen on changing it.