For the most part they still suck at anything resembling real spatial reasoning but they're capable of doing incredibly monotonous things that most people wouldn't put themselves through like meticulously labeling every pin or putting strict design rule checks on each net or setting up DSN files for autorouter. It even makes the hard routing quite easy because it can set up the DRC using the Saturn calculator so I don't have to deal with that.
If you give them a natural language interface [1] (a CLI in a claude skill, thats it) that you can translate to concrete actions, coordinates, etc. it shines. Opus can prioritize nets for manual vs autorouting, place the major components using language like "middle of board" which I then use another LLM to translate to concrete steps, and just in general do a lot of the annoying things I used to have to do. You can even combine the visual understanding of Gemini with the actions generated by Opus to take it a step further, by having the latter generate instructions and the former generates JSON DSL to that gets executed.
I'm really curious what the defensibility of all these businesses is going to be going forward. I have no plans on entering that business but my limit at this point is I'm not willing to pay more than $200/mo for several Max plans to have dozens of agents running all the time. When it only takes an hour to create a harness that allows Claude to go hog wild with desktop apps there is a LOT of unexplored space but just about anyone who can torrent Solidworks or Altium can figure it out. On the other hand, if it's just a bunch of people bootstrapping, they won't have the same pressure to grow.
Good luck!
[1] Stuff like "place U1 to the left of U4, 50mm away" and the CLI translates that to structured data with absolute coordinates on the PCB. Having the LLM spit out natural language and then using another LLM with structured outputs to translate that to a JSON DSL works very well, including when you need Opus to do stuff like click on screen.