It does. Here’s the issue:
On normal you’re blasting through enemies at record pace. On very hard, they will do almost as much damage as you, causing you to play more defensively. When this happens, they will do multi-tiered flanks(one guy going around from behind to stab you, another entering from a side door to shoot), provide their teammates cover to flank by shooting a full magazine at you, use grenades, use smoke-style grenades, use jump jets to get to higher spots to snipe, escape and regroup, etc.
All of these things has happened in my playthrough and some of it genuinely took me by surprise, in a good way.