The biggest issue standing in the way before we universally adopt WP Meta SEO on all our Wordpress sites is a dedicated "focus keyword" field and more advanced keyword analysis.
It appears that the current edition assumes that the focus keyword will be the Wordpress page title, but this isn't how everyone manages content. It would make sense for a new "focus keyword" field to default to the page title if no other keyword focus is specified, but we'd appreciate the opportunity to name our pages differently than the actual primary search engine keyword we're competing for.
Additionally, it appears that the current analysis searches for the title word in the content and content headings, but doesn't factor in frequency and density, which play a big part in on-page SEO optimization. Apparently, the page optimization doesn't even check for the keyword at all in the meta title, meta description, or image meta alt text. These should all be analyzed for keyword inclusion as well.
Another facet of managing a "focus keyword" field should be checking for duplicate focus keywords across all the content types, in a similar way that the current plugin checks for duplicate title and description fields.