When I began making ketubot, there was a strong interest in egalitarian ketubot. I have seen everything from liberal Jewish couples who didn't see themselves fitting into traditional marriage language write their own texts in English and have me translate their texts to Hebrew, to traditionally observant couples who wanted a chalakic (legal according to Jewish tradition) ketubah that satisfied the tradition but also recorded their emotional commitment to each other. In that case, they found an Orthodox rabbi who agreed that they could add a separate section as the tena'im that addresses their emotional commitment to each other.
Mostly, couples are interested in and expect to express an emotional commitment rather than signing a contract that protects the bride in case of death or divorce. I have done a few traditional ketubot over the years and nearly all of them chose to have an English section that spoke to loving each other. This reflects women's expectation of greater financial independence regardless of marital status. Also, those interests tend to be addressed in civil law, leaving couples to explore the personal significance of their commitment.
The biggest change I have seen is same sex couples looking for ketubot. I have even been asked about making an Orthodox Aramaic ketubah for two men. I wholly support all Jewish couples trying to make sense of their relationships in a Jewish context, even if some of our answers would have surprised the sages of the Talmud.
The traditional ketubah asks us to not regard the ketubah as a form empty of meaning. Couples are finding ways to make Jewish tradition relevant in their lives, for some that means rewriting texts in ways that reflect their lives as they are lived. For others, that means upholding a tradition even if they are not sure how it will play out in their lives. This struggle seems essentially Jewish: how to live Jewishly with meaning and integrity.