You will get less reception than a normal phone. I had an apple watch and would lose coverage sometimes within 500m from shore (vodafone though).
on a run to rottnest (~20km) i didn't have coverage for most of the trip.
you can't really hear someone if its blowing but if my missus rang me i could answer and yell 'ON THE WATER, HOME AT 6' and she could understand me. Then she would text and tell me whatever it was i had forgotten to do.
if i came into beach i could have a convo by holding watch to ear, and on light wind foil days could have a chat ok. If you're bunking off work for a light wind foil it sounds enough like you're on the toilet that it buys you time to get back to the shore and answer properly (probably, not that you would do that).