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I have three stories, which I'll try to make as short as possible.

1. My husband and his twin brother were DXed ADHD at around 5. My husband took meds until midway through high school, it was really messing with his weight and he was tired of taking the meds. In college his grades plummeted so much that he went back on meds for his last year to make sure that he would pass all of his classes. He has developed a lot of coping mechanisms over the years and has not been on meds since graduation--it can cause some problems every once in a while at work, but he is doing pretty well.

2. My little sister always had behavioral problems and was never able/willing to do her homework/housework/organized sports/anything that required attention. We didn't know what was going on until at 17 her pediatrician recommended her to a psychiatrist to go through ADHD screening. Turns out that they DXed her with ADHD. She tried Strattera first, but that did nothing. Then she tried Adderall XR, and it was really rough on her. Eventually, she got put on Vyvanse and is doing so well--her attitude/personality and grades have completely changed. Downside (though she doesn't see it as such) is that she went from being a size 6 to a size 0. She also moved up from 30 mg to 70 mg very quickly. ETA: I think that if she had been medicated at 6, school and life generally speaking for my little sister would have been a lot easier--but YMMV, especially since I do not believe that would have been the case for me.

3. I was never a problem child and always did well in class. I, however, also spent HOURS on my homework (everything from reading pretty slowly to spending a lot of time changing the font on a document). I love reading, and as early as the age of 5 I would have three books in front of me and read one page of each because I couldn't just read one book at a time. In college I had trouble keeping up with the reading because I had keep reading the same paragraph over and over again. Before I knew it I would have spent an hour trying to read five pages. I found out that if I played an audiobook at crazy high speed while reading in the book, it forced me to read very quickly and stay focused on the content. I procrastinated on papers, but at the undergraduate level it wasn't too big of a problem.

In graduate school, that doesn't work because I am often reading articles and books that don't have audiobooks, and it is just not okay (or healthy) to write a 30-page publishable-ish paper in the wee hours of the morning the day it is due. I was really struggling, especially because the material is interesting to me and I genuinely love what I'm doing. Additionally, research was awful because I would start reading an article and then latch onto something interesting in it and start researching that topic, leading me down a rabbit hole that just didn't allow me to get any writing done because I was spending a lot of time researching interesting, but unhelpful and irrelevant stuff. Worried that I was starting to get depressed, I called my mom and talked to her about it. She told me that after all of her reading on ADHD for my little sister, she thought it would be a good idea for me to get screened, too. After several weeks of testing, I was DXed ADHD at the age of 23. Thankfully my sister already did the medication rollercoaster, so I was immediately put on Vyvanse. It has helped me so much. It is no miracle pill, and at 5' 5" 105 lbs. I have to be very careful to make sure that I am eating during its peak effectiveness (between breakfast and dinner) when I really feel the anorectic side effects. I don't want to be on the pill forever and want to try and take a one-month break over the summer, but Vyvanse (along with developing a VERY detailed daily schedule and using the Pomodoro system) has really been a lifesaver for me. I have stayed at 30 mg for ~8 months now, and although I don't feel the initial "kick" that I felt during the first few weeks I have refused to raise my dosage based on talking with my husband and doing some research. I'm convinced that while I might not get that same feeling, the meds are working because when I make the decision to focus on something I can in a way that I was not able to before taking anything.
Downsides: anorectic effect and I have to be REALLY careful to not get pregnant while I'm taking it (which also means I'm going to have to develop some adequate coping mechanisms for when my husband and I decide to have kids).
ETA: I think if I had been medicated earlier on, my life would have been made marginally easier, but I was bright and able to develop a lot of coping mechanisms on my own until I got to graduate school. I'm not sure if in my case (as opposed to my sister's) being on medication would have been worth the downsides. Just some food for thought.