If the lecturer is good, it can be managed well. I use lots of breaks, tasks for them to do in groups and so on. I also have tutors who help go round the room and help anyone when I have given them something to work on.
In part, this is driving the Prof's plans. The day with him has a bit of lecture, break out rooms, working on a brief, developing something in teams and presenting work. Is that better than showing up for a bog standard lecture every week? Maybe. But it is designed for big classes.
Biggest class I ever had was 454 students. But that was during covid, and only 50 were with me in person. The rest were watching online. We don't even have a room big enough for all of them.