Oh man, a previous company I worked at had an issue with a hot table (frequent reads + writes) interfering with autovacuum. Many fires over a six month period arose from all of that. I was (luckily) only on an adjacent team, so I don't know the details, other than vacuums taking over 24 hours! I'm sure it could have been prevented, but it seemed horrible to debug
Last I checked (....a few years ago, so things may have changed,) the theory of autovacuum heuristics may not have changed much since the turn of the millennium, they're probably about due.