Are.there always some physical signs w/ acromegaly in adults like nose widen, hand/feet growing? or can you have it w/ no symps other than height gain

It depends on level: It depends on how high the level of hormones are? Some may have mild symptoms.

Not height gain: Once the growth plates in bones have closed (by age 20) you will not increase in height, no matter how much GH is there. Acromegaly in adults involves thickening of bones and features, but not linear growth. Keep in mind that there can be minor changes in spacing between the vertebrae, which could account for variation in measurements from time to time. Maybe 1 inch.