Return more specific status code in case the file is not available (for example, it may not be available because there is no resource with the given UUID, or there is such a resource but still no file, or ...)
Give more specific meta information like a "file name with extension" suggestion and the file's media type
The disadvantages are
Additional strain on the .NET Webserver with long-running requests
More difficult to implement properly (the files should be streamed)?
The advantages are
The disadvantages are
For a possible implementation see https://github.com/dotnet/AspNetCore.Docs/blob/b4599432690b8753fc2eac23d52957f47e01997a/aspnetcore/mvc/models/file-uploads/samples/3.x/SampleApp/Startup.cs#L51-L72