It can be quite a headache.
I ran into a guy online that couldn't obtain an ID, period. The only form of ID he had was a driver's license. His doctor pulled it (legitimately, but needlessly--there was no question he was incapable of driving) leaving him with nothing. Where he lives that left one option--get a birth certificate. The application must be signed--something he's no longer capable of doing. The only other route would be to show up in person at the right office--multiple states away, a trip that would be medically ill-advised.
Note that he's educated and not poor, this is purely a problem of the system not handling the oddball cases. That state needs to be clobbered with a clue-by-4, if you pull a driver's license you should issue the person a non-driver's ID!
We have also run into a problem. When my wife was naturalized a hyphen got inserted in her name on her naturalization certificate, it wasn't noticed at the time. Almost everything is in her name as intended but social security saw the hyphen and would not relent. Even after we legally changed her name to rid it of the hyphen they were digging in their heels on changing the records. At this point we *think* the Real ID stuff is going to work, but the virus interfered. For the occasional place that won't accept her expired ID we use her passport card. (She doesn't drive, there's no issue of driving on an expired license.)