Doesn't that depend a lot on the project? Only one datapoint, of course, but we have an elixir project at work and it's in dire need of a refractor. The dynamic nature of the language doesn't help.
Thing is, it's not 100% dynamic. It's compiled, so most common refactor errors will be revealed by that alone(no function named, not the right number of arguments, etc). The harder to find things would be harder to find in most typed languages too, unless you had tests to point them out to you.
That's one of the things you lose when going from Erlang to Elixir. Sure the macros are useful and convenient, but they also make the code less explicit and harder to refactor. There's probably a reason why Erlang for the past 30 years had no macros, despite being a homoiconic language.
TLDR: try working with Erlang if you find your Elixir code-base in need of a refactor - chances are you'll learn conventions which will help you write more maintainable code in Elixir, too.