*spoilers*
It's hard as nails on certain parts. Regular missions aren't too bad but the part where you meet Kaiden/Ashley is difficult and the the first time on the Collector ship is difficult. Everything else isn't bad, you just have to play very slow and methodical and can't really have fun with the combat like you can on the other difficulty settings.
Insanity also exposes how crappy squad mate AI is. Your team mates will routinely take cover in front of an object or take cover on top of an object, resulting in an instant death for them. It's not rare to have both partners die within 5 seconds of a mission starting because they did something boneheaded like standing on top of a crate to shoot rather than taking cover behind the crate.
I'd suggest getting Dominate. A lot of people sleep on it but Dominate was a lot of fun for me. There's nothing like being stuck in cover from two rocket guys and casting a Dominate and then they one takes out the other. You can trap baddies in a loop or make them take turns being Dominated. That + Combat Drone is super helpful because it's a lot easier to stay alive when everyone is focused on killing their friends or a drone.
The only bad part is that it takes FOREVER to get the people who can do both of those abilities and they work best when you're not casting them yourself.
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