'Scale' is increasingly being used as shorthand for 'scale up' (“to grow or expand in a proportional and usually profitable way”). I think it’s also important to understand that sometimes scale can be depth and breadth.
When looking at your business, I believe everyone needs to look at scale at some point along the way, no matter how big your company is, or whether you offer services or products. Perhaps you need to scale in the ways that your time and energy is spent. That doesn’t fall into the “Scale Up” mindset, but in looking at ways you can maximize the time you spend with your business, it counts as scale.