In a larger company a chief engineer isn't doing low level technical work, but they are normally an engineer with deep domain knowledge of the low level work be

In a larger company a chief engineer isn't doing low level technical work, but they are normally an engineer with deep domain knowledge of the low level work being done, and not a CEO-type also responsible for other companies and the company's commercial priorities. So no, I don't think the design of Starship looks any different if he decides he's too busy to attend design meetings because of his other five jobs. Their other top level execs are very, very good engineers. SpaceX also wasn't very big in the early years, and the CTOs and chief engineers of the space launch startups I know absolutely do involve themselves in the low level technical work. I don't imagine Elon did much of that even when he did make a point of interviewing every new hire and sitting in on meetings about low level purchasing decisions.