Drawbacks of SLI, beside cost, power and potentially (when on air) noise?
1. Relying on driver releases or profiles to get good scaling in some games. Usually, scaling is very good, sometimes close to 100%. In some games, SLI scaling doesn't come with the game "out of the box", you have to wait for a driver or patch. Worst case scenario is that the game never really supports SLI, and provides no or very lousy scaling. It's pretty rare, though.
2. Random problems or constraints in some games that don't happen on a single GPU. Flickering textures/shadows or alt-tabbing issues are an example - usually patches take care of that but not always. Examples: flickering HDR sky in Fallout 3, no Bokeh filter in JC2. Most of these issues are not deal breakers but can be annoying.
3. Microstuttering and input lag. Both are IMO blown out of proportion but they do exist. In games like Crysis or Metro 2033 where even SLI systems don't offer stellar fps in eye candy high res modes, games can often feel smoother on a single GPU, despite lower frame rate.
In a nutshell:
A. Modern SLI setups are fast and scaling is usually great.
B. IMO, it's only reasonable to buy a high-end SLI setup (like 480 SLI) if you can take the power consumption, heat and possibly noise. Buying midrange SLI setups doesn't make sense, I'd take a single GPU high end card any day, even if it's slightly slower.
C. SLI is and probably never will be as robust and reliable as a single GPU card. Problems are usually minor and are rare but they're present.