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What difference does it make? It was still a pandemic that wasn't planned, and many people lost their lives or had their lives severely affected as a result. And a certain US president, I will not name any names, completely mismanaged it, because it took his name off the frontpages of the news papers and Fox News.
Other governments were also completely idiotic in their response.
My government, for instance, had a different roadmap out of Covid lockdowns every week or so. Our minister of security at the time held a wedding reception while the rest of the country was in lockdown. And our Prime Minister ("teflon Mark Rutte") just laughed it all away.
So it's not just the US where the government was stupid, but we didn't have morgues overflowing with dead bodies where they were stored in refrigerated trucks on the street, but we did have overflowing ERs and nurses on the brink of burn out, because the finances for those care units had been stripped because of neo-liberal policies in the past decade or so.
I think one difference it makes, to answer your question, is that unsubstantiated claims like this tend to spread, virus like. Especially when pedalled by presidents and official government agencies. Many governments handled the pandemic predictably awfully, but this false narrative can have dangerous consequences, too. I'm worried about the number of times I've seen 'plandemic' spoken about. It gives me the impression that simply through repetition the meme grew stronger. But now it's being echoed by_official statespeople. _
The difference is that it'd allow the attribution of negligence which could be used for geopolitical gain.
E.g. "Government X's bad management of COVID wouldn't have been an issue if China wasn't leaking deadly diseases out of research institutions. So Government X deserves compensation for the harm China caused to the people of Government X. So X will institute trade sanctions of China."