It probably does not really matter a lot -
but if there is a design/image that has an obvious up/down - such as a snowman - I like the design to be with the head going up and the base going down.
I realize that our world has gotten a bit bonkers - but when looking at the quilt in its "usual" setting - such as on a bed - direction does matter to me.
Taking pictures of lay outs is helpful. Sometimes "the camera" sees things more objectively that "we" do.