In my experience, there's been many a slip 'twixt cup and lip on this point.

Short advice: Call to confirm what you want on this stay. In my case, my profile has me, the solo business traveler. But when I must have two beds for my son and me, and I forget to change my profile, I think a good faith human intervention often occurs the day of, or the night before, in which someone says, "That can't be right," and overrides what I special-called in the reservation. If I don't have the time to align my profile and the reservation for that stay, I try to put a very assertive confirmation of what I want in the notes space. Obviously, this is especially important when it's a high-occupancy time.

I've also encountered a hang-up when the hotel's suites are only single-bed, as at the Grand and the Mission Bay in San Diego, and we had to have two. Then it's important to follow up and be sure that your suite certificate gets re-deposited in your account...