You could be bound by new, potentially less favorable terms simply by continuing to use the service, even if you did not actively review or agree to the changes.
Twilio's ToS primarily affects developers and businesses who build on the platform rather than end consumers directly. Key impacts include mandatory arbitration that waives class action rights, significant indemnification obligations that shift legal risk to customers, and Twilio's broad right to suspend or terminate accounts with limited notice. You can opt out of arbitration by sending written notice to Twilio within 30 days of first accepting the terms.