Parachuting down to the bottom of the thread with a few thoughts:
In the Air Force, we only wear our ribbons with our blues, and our medals pretty much only when they’re presented or when in Mess Dress (assuming we own a set of that…) I think I was only ever presented with a couple of my medals, the others just sort of popped up in my record when I had earned them and I went to the BX to buy the ribbon.
Incidentally, National Defense Service Medal is one of the ones that just sort of popped up in my record. When we were in Basic, our instructors gave us a list of which ribbons to buy from the shoppette near our dorm and what order to put them on our ribbon racks in.
At least where I’m stationed, we wear blues rarely enough that the ribbons become a casual topic of discussion just because we rarely get to see each other’s ribbon racks. I’ve been told I have a spectacular looking rack, although most of it is purely for participation. Also helps that Air Force requires “All or Nothing” when wearing ribbons with our blues. Every so often you’ll see a ribbon that pops out because you didn’t know they, for example, deployed to Iraq, or received the Purple Heart, or spent time in Antarctica.
I have one foreign decoration, a NATO Non-Article 5 medal, which Air Force regs state goes at the far bottom left of the rack.
I also have a number of Civil Air Patrol awards, which are not authorized on the USAF uniform at all (CAP is a civilian organization, despite the military style uniforms and bling). Conversely, all of my USAF awards are authorized on my CAP uniform. The one time I showed up to a CAP meeting with my full rack of USAF and CAP ribbons, everyone else teased me for all of the bling I had on my uniform (lots of CAP folks are retired military, and usually don’t fuss with most of the military stuff on the CAP uniforms).
If one of my airmen showed up in blues with whatever on his ribbon rack, I probably wouldn’t know at a glance what he should and shouldn’t have unless something really out of place turned up, like if they had an Iraq campaign medal with three service stars as an E-3 in 2017, or some particularly distinguished award. (I don’t have easy access to their awards and decs listing without digging through PRDA to find each award citation and set of orders, which I’d need to cross-check with what years which units received awards… frankly, I have better things to do with my time) I might notice if some of the awards I was familiar with were out of place.
In the event that I wanted to be particularly picky, as does happen from time to time (such as if an Airman was expected to report to an awards board or meet a visiting general or some such), I’d have them print off their Awards and Decs listing from vMPF so I could check it against their ribbon rack. Most of the time though, we don’t wear our blues at all except for special occasions, so I’m mostly looking to see that their camo uniforms are clean, properly fitting, and have the right rank and badges on them.