Hello Glenn Maxwell,
Welcome to microsoft Q&A,Thankyou for posting your query here.
There's no direct impact on your Exchange licensing by changing VM sizes, as Exchange licensing is not based on the hardware or VM size but on the number of mailboxes and the type of licenses (Standard/Enterprise) you own.
Resizing should not affect your data, but it is good practice to create recent backup of your exchange databases and server configurations.
Resizing a Virtual machine requires downtime of the server. So to overcome this period of downtime you can consider using azure scale sets which increasing the VMs based on the usage of CPU and DISK.
please refer this documentation for resizing the VM.
https://learn.microsoft.com/en-us/azure/virtual-machines/sizes/resize-vm?tabs=portal
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