It's been a long time since I last fired up OW (like 10yrs) and it's still being updated it appears. I was looking at some of the changelogs, but I'm not sure I understand what's going on. So I was wondering if anyone could give me a quick overview of where the game is at now. What do the latest patches actually do for the game, and is there anything I should be getting with them (new campaigns/mods and the like)?

You can get patches from:
https://update.owsupport.com/ (Same as Steam)
https://update.owsupport.com/beta (Version most use for multiplayer and some mods require)

If its been 10 years then there is a lot of changes. Most expand modding. But there has been a lot of QoL (Quality of Life) as well.

In general we have tried to keep Original War looking and acting the same with Vanilla. So apart from the main menu when using the modern UI, it should look mostly the same.

P.S I don't check GoG forums that much hence the late reply.