So I monitored both the air pressure measurement on my watch and the calculated altitude from it using a weather service as referece.
The air pressure goes up and down as expected with changing weather, but the value is 10-14hPa higher than the pressures as stated on a local weather service website.
The calculated altidude is lower because of the air pressure being measured too high, in my case it moves between -20m to -180m (the part of Holland where I live actually is below sea level, but not that much).
Someone else stated in another post that with quickly changing weather, the database that is being used by the watch as a reference can't keep up, which I think is plausible. This adds up to the inaccuracy of the altitude calculation.
So I guess you can't really use this feature on the watch if you need accurate pressure and/or altitude.
I guess what you can use it for is to predict showers or good weather coming up because of a rapid change in air pressure (which the watch does by default), but we have much better apps for that, also on the watch.