Appsignal is very very good! I highly recommend it for Elixir projects if you only use elixir and need something setup fast. It's awesome!
I also highly recommend looking into spans and tracing (if you use multiple languages together), then you can use something like spandex with elixir and other languages to do tracing across languages. It's excellent with datadog.
I've been very happy with AppSignal for my Elixir projects (introduced them to 3 paying customers).
I especially like their request-based pricing model. It makes it a no brainer to put it on every rails/elixir project under one account (per paying customer).
Disclaimer: they have sent me a box of delicious cookies for creating an open source plugin (ember deploy plugin for automatically uploading source maps to AppSignal). But I have liked them way before that :)
AppSignal's monitoring shows useful metrics but does not allow examining the supervisor tree and other things possible with Observer and other OTP tooling. In some sense, it's not a live debugging tool but a monitoring dashboard.
I tried out AppSignal for Elixir and was disappointed that the BEAM metrics don’t include scheduler utilization, which is kind of a proxy for CPU usage. IIRC there was scheduler count but not utilization metrics.
I also highly recommend looking into spans and tracing (if you use multiple languages together), then you can use something like spandex with elixir and other languages to do tracing across languages. It's excellent with datadog.