Even in RQII days there were exceptions to this rule and there was a much more standardised cult structure then.
I think it's probably still the case for organised cults such as Yelmalio, Humakt, Yarnfal Tarnils and similar. For many it'll be cult matters only - an Issaries devotee will have authority over decisions about trading matters, an Uroxi devotee will be able to call initiates to join him fighting chaos. Following those orders isn't always obligatory but not doing so will generally damage the initiates relationship with the cult.
As for recognition I think devotees will be easily recognised by anyone familiar with the cult. Tattoos for Heortlings, badges and other insignia for Lunars, heraldic motifs for westerners. This does allow someone to pretend to be members of a cult they're not but it's a risky business both magically and from the real members who don't take kindly to such things.
-- Donald Oddy http://www.grove.demon.co.uk/
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