As with basically every single aspect of Fallout 4, the spouse and PressXtoSHAAAAUUUUN were huge wasted opportunities.
With the theme of synths replacing people and the whole Blade Runner-esque "More human than human" thing the writing could have gone so many surprising ways, especially in the interactive medium of a video medium. Have your spouse woken up before you and then synth-cloned, and in the end you have to decide who is the real one. And the only way to be sure is to kill them. Let your spouse be an adventurer like you (but then he or she took a Fatboy to the knee... But it's okay, a stimpak healed it immediately), working basically against you throughout the game, reacting to your actions, and you only find out at the end.
Or have the player synth-cloned, with the other one working against you in a similar fashion... And in the end you can only find out for sure if the player or the antagonist is the synth by killing the antagonist. Let the game right in the beginning decide randomly wether the PC is a synth or not (anyone played the Blade Runner PC game?), and the player can find vague clues wether he or the antagonist is the synth.
Have your spouse thawed out and live a new life in the wasteland thinking you're dead, finding a new husband or wife and having more kids... One of them being named after him or her and being the right age, making the player chasing after him or her, only to realize in the end that your actual spouse is already dead, and that the person you're chasing is actually the offspring of your spouse.
Or you find your spouse early on, but it's a synth clone which you only realize when you find a hundred year old grave at the end.
So many possibilities to fuck with the player with that kind of theme going on. But instead, all you get is some talking to DiMA where you can't remember anything before the start of the day, despite being able to remember other details like how baseball works and so on.
So fucking sad.