No job is perfect and MHD is the same, there will always be things that happen that bother people or are frustrating.
Smaller companies can change very rapidly in short periods of time and if you're good at what you do, you'll get more responsibility and may often find yourself wearing multiple hats. Some people view this as a bad thing but personally, it made things more fun.
Its easy to burn out in the MSP world in any position, so expect times where things are crazy and you have to step in and help in ways you might not have expected.