If you're talking about black smoke out of the exhaust, no it doesn't help reliability. If you just mean tuning to optimize not for emissions, yeah it can help if you know exactly what you're doing or screw it up if you don't, either way you'll only find out later. Doesn't seem to matter because most professionals already make their living without messing with their trucks.
idk who downvoted you, that's not appropriate, so +1'd you to avoid comment death
The fact is, emissions regulations in many ways have nothing to do with health or clean air. I don't drive a diesel truck myself so its not like I'm trying to defend my own behavior or anything. I'm a former automotive engineer who is unfortunately very familiar with the regulations and how nonsensical they are.