There’s a name I like with a lot of significance to me. It’s not a favorite of mine, so I’d likely use it in the middle spot. The only problem is it sounds really awful when said out loud with my last name. I see this as a non-issue for the most part, but I wanted to get some thoughts. Would bad flow be a deal breaker for you? What about bad flow with first name-surname?
Not a huge deal to me, if it’s meaningful
Absolutely not a dealbreaker, especially if it’s a meaningful name! If my surname was [name_m]Lancaster[/name_m], I’d still use [name_f]Annabel[/name_f] as a middle name if she was quite meaningful to me (for example). 
Same goes for first name! [name_f]Alice[/name_f] is a major favorite or mine, but I’ve my surname was [name_m]Stein[/name_m], I’d still use [name_f]Alice[/name_f]!
Middle name - last name flow is a non-issue for me too. When it comes to first name - last name, if I loved two names equally and was having a hard time choosing between them, one name sounding better with our surname could tip it in that name’s favour, but flow alone wouldn’t be a deciding factor.
I can’t deny it would bug me a bit, but it was a name I loved with personal meaning to boot, that would definitely outweigh any flow issues.
The only exceptions would be if it was literally almost the same as my surname, or made an embarrassing phrase. Examples: [name_u]William[/name_u] [name_m]Adam[/name_m] [name_m]Adams[/name_m] or [name_u]William[/name_u] [name_m]Hardy[/name_m] [name_m]Dixon[/name_m]. I’d try to find an alternative in those cases.
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It would be a non-issue for me in the middle name spot but I would seriously look for an alternative as a first name. The first name/last name combo is really the only way most people know you as, so of primary importance.
Flow isn’t a big deal for me in general, and it definitely isn’t when it comes to middle name - surname flow. People would hardly ever hear in anyway.