Not Orchestra but I've been on another MSC cruise in Europe. I found entertainment better than other maintream lines (appreciating the variety instead of just music/shows), the ship was impressive for the time, but admin was 'typically Italian' i.e. not so great if needed/exceptional circumstances arise (but that's fortunately not a major part of a cruise). That was the only significant negative for me.
cruisecritic being American based means lower ratings when not US aligned. e.g. the fact you need to pay for water when dining in line with Italian custom and other differences like multi-lingual announcements means they'll get marked down by those who like things to be the way they're used to. Menus are similarly Italian based e.g. pasta is a main dinner option each night - but with local specialities, again different from the usual US standard. Similarly, activities are different because of the multiple languages onboard instead of just English speakers.
As long as you're happy to go to Italy and have it be Italian (instead of just like home) you'll be fine. However, if you do want it to be like US mainstream cruise lines then you may prefer the traditional US choices more.
