No, I really don't make adjustments. My BOB is mainly a modified camping bag, with my real camping gear next to it. My sleeping bag is in it's own bag, so ideally if I have to bug out, I'm picking up my BOB in one hand and my sleeping bag in the other. I can pack it down later and get it secured.
Given the various places I've lived (5 states in 5 years!), I just figure I'll be dressed appropriately anyway. Put on a jacket as I leave the house is pretty much my "dress for egress" mentality. Maybe grab a fleece or something extra, but most of my heavy coats have a ski cap and gloves tucked into the pockets already - I tend to lose them, and it just makes more sense for me to store them all as a combo.