Whenever I want to use pictures, to host/post on forums like this, or submit medical reimbursement, etc etc, I end up having to change Safari's Developer menu to force download as JPG out of iCloud. This is not the end of the world, but somewhat tiresome, especially as I often forget the first time. Apparently I can set iPhone to "most compatible" which would then take the pictures as JPEG instead of HEIC. What are the downsides to that?
Jpegs are lower in quality and larger in file size but probably not enough to notice in your use case.