A business will typically test and verify updates before pushing then out to their employees.
Businesses which allow its users to perform updates directly from Microsoft already face the issues you describe. (Many updates can and have caused issues. Especially the occasional broken patch that gets rolled back shortly after release).
I can certainly see this being an issue for support companies. On the other hand, they will likely still have some form of versioning to base their support on. "Sir, please do XXX. You should see something saying Windows 10 Service Pack and then a number. Can you please tell me what that number is?"