It's not as bad as in npm with node_modules, because .NET provides a lot of base functionality in the standard library.
But when you start to use multiple nuget packages, sooner or later you will also enter dependency hell, where managing versions and updates of nuget packages gets very painful.
All in all we have to reference about 10 external libraries. The visual studio nuget package manager started to be frustrating if you need to manage those dependencies in multiple solutions. We therefore switched to Central Package Management [1], but then you realize, that you're just shifting the problem around. Now we have to put the whole dependency tree into the file 'Directory.Packages.props' and have to manage the version of 140 libraries. If there are version conflicts, we force nuget to use the latest version and just hope for the best.
Managing versions of dependencies and dependencies of dependencies is a major pain, but it's an ubiquous pain all programming environments share. And no, .NET won't relieve you from that.
[1] https://docs.microsoft.com/en-us/nuget/consume-packages/cent...