Yes, with any format, when you get to a magnification of 1:10 (subject on film:subject's actual size), then you need to think about exposure factor. Of course the larger the format, the sooner you'll be in that territory. With 35mm, it's pretty much just closeup work where you'll have to think about exposure factor, if you are using non-TTL metering or non-TTL auto flash. Even with TTL metering, meters can get pretty non-linear in low light, and you often have very low light with macrophotography. With medium format, you're in exposure factor territory with a tight portrait--maybe just 1/3 or 1/2 stop, but if you correct for it, you'll get better results.
I like to figure exposure factor as a function of magnification, because it works the same way with any camera, any format. Here's an explanation and a little table for converting magnification factor to exposure factor that you can tape to the back of your camera or wherever it's handy--
(there was a url link here which no longer exists)