What it asks for. The organisation must develop, document and disseminate an access control policy and procedures, designate an official to manage them, and review and update them at defined frequencies and after relevant events.
In practice. Doing this well means a concise policy setting principles such as least privilege, need to know and separation of duties, with procedures for granting, reviewing and removing access. A named owner keeps it current. Auditors expect the approved policy, evidence of communication and review records. ISO/IEC 27001 access control policy requirements are equivalent.
Common gaps. Policies often describe a target state that procedures and systems do not match. Reviews are skipped or done without real changes after major technology shifts such as cloud adoption.