It really depends on the environment tbh. I know just for the "low distraction environment" accomodations, those normally aren't used for small classes but they are used for the big exams where they stuff the entire freshman class in the program into a series of auditoriums.

And of course some professors do double time accommodations by having the students take the test with everyone else and then follow the teacher to their office to finish the exam afterwards but tbh I didn't see that very often.