Eu tentei de duas maneiras:

Método 1:

label.font = UIFont.preferredFont(forTextStyle: UIFontTextStyle.body)
label.adjustsFontForContentSizeCategory = true

Isso funciona bem, mesmo quando o tamanho do texto preferido é alterado nas Configurações, o tamanho do texto muda automaticamente, mesmo antes de voltar para o aplicativo.Mas ele funciona apenas com a fonte do sistema (San Francisco).

Método 2:

Para usar uma fonte personalizada, adiciono uma extensão aoUIFontDescriptor:

//from this answer http://stackoverflow.com/a/35467158/2907715
extension UIFontDescriptor {

    private struct SubStruct {
        static var preferredFontName: String = "Avenir-medium"
    }

    static let fontSizeTable : NSDictionary = [
        UIFontTextStyle.headline: [
            UIContentSizeCategory.accessibilityExtraExtraExtraLarge: 23,
            UIContentSizeCategory.accessibilityExtraExtraLarge: 23,
            UIContentSizeCategory.accessibilityExtraLarge: 23,
            UIContentSizeCategory.accessibilityLarge: 23,
            UIContentSizeCategory.accessibilityMedium: 23,
            UIContentSizeCategory.extraExtraExtraLarge: 23,
            UIContentSizeCategory.extraExtraLarge: 21,
            UIContentSizeCategory.extraLarge: 19,
            UIContentSizeCategory.large: 17,
            UIContentSizeCategory.medium: 16,
            UIContentSizeCategory.small: 15,
            UIContentSizeCategory.extraSmall: 14
        ],
        UIFontTextStyle.subheadline: [
            UIContentSizeCategory.accessibilityExtraExtraExtraLarge: 21,
            UIContentSizeCategory.accessibilityExtraExtraLarge: 21,
            UIContentSizeCategory.accessibilityExtraLarge: 21,
            UIContentSizeCategory.accessibilityLarge: 21,
            UIContentSizeCategory.accessibilityMedium: 21,
            UIContentSizeCategory.extraExtraExtraLarge: 21,
            UIContentSizeCategory.extraExtraLarge: 19,
            UIContentSizeCategory.extraLarge: 17,
            UIContentSizeCategory.large: 15,
            UIContentSizeCategory.medium: 14,
            UIContentSizeCategory.small: 13,
            UIContentSizeCategory.extraSmall: 12
        ],
        UIFontTextStyle.body: [
            UIContentSizeCategory.accessibilityExtraExtraExtraLarge: 53,
            UIContentSizeCategory.accessibilityExtraExtraLarge: 47,
            UIContentSizeCategory.accessibilityExtraLarge: 40,
            UIContentSizeCategory.accessibilityLarge: 33,
            UIContentSizeCategory.accessibilityMedium: 28,
            UIContentSizeCategory.extraExtraExtraLarge: 23,
            UIContentSizeCategory.extraExtraLarge: 21,
            UIContentSizeCategory.extraLarge: 19,
            UIContentSizeCategory.large: 17,
            UIContentSizeCategory.medium: 16,
            UIContentSizeCategory.small: 15,
            UIContentSizeCategory.extraSmall: 14
        ],
        UIFontTextStyle.caption1: [
            UIContentSizeCategory.accessibilityExtraExtraExtraLarge: 18,
            UIContentSizeCategory.accessibilityExtraExtraLarge: 18,
            UIContentSizeCategory.accessibilityExtraLarge: 18,
            UIContentSizeCategory.accessibilityLarge: 18,
            UIContentSizeCategory.accessibilityMedium: 18,
            UIContentSizeCategory.extraExtraExtraLarge: 18,
            UIContentSizeCategory.extraExtraLarge: 16,
            UIContentSizeCategory.extraLarge: 14,
            UIContentSizeCategory.large: 12,
            UIContentSizeCategory.medium: 11,
            UIContentSizeCategory.small: 11,
            UIContentSizeCategory.extraSmall: 11
        ],
        UIFontTextStyle.caption2: [
            UIContentSizeCategory.accessibilityExtraExtraExtraLarge: 17,
            UIContentSizeCategory.accessibilityExtraExtraLarge: 17,
            UIContentSizeCategory.accessibilityExtraLarge: 17,
            UIContentSizeCategory.accessibilityLarge: 17,
            UIContentSizeCategory.accessibilityMedium: 17,
            UIContentSizeCategory.extraExtraExtraLarge: 17,
            UIContentSizeCategory.extraExtraLarge: 15,
            UIContentSizeCategory.extraLarge: 13,
            UIContentSizeCategory.large: 11,
            UIContentSizeCategory.medium: 11,
            UIContentSizeCategory.small: 11,
            UIContentSizeCategory.extraSmall: 11
        ],
        UIFontTextStyle.footnote: [
            UIContentSizeCategory.accessibilityExtraExtraExtraLarge: 19,
            UIContentSizeCategory.accessibilityExtraExtraLarge: 19,
            UIContentSizeCategory.accessibilityExtraLarge: 19,
            UIContentSizeCategory.accessibilityLarge: 19,
            UIContentSizeCategory.accessibilityMedium: 19,
            UIContentSizeCategory.extraExtraExtraLarge: 19,
            UIContentSizeCategory.extraExtraLarge: 17,
            UIContentSizeCategory.extraLarge: 15,
            UIContentSizeCategory.large: 13,
            UIContentSizeCategory.medium: 12,
            UIContentSizeCategory.small: 12,
            UIContentSizeCategory.extraSmall: 12
        ],
        ]

    final class func preferredDescriptor(textStyle: String) -> UIFontDescriptor {

        let contentSize = UIApplication.shared.preferredContentSizeCategory
        let style = fontSizeTable[textStyle] as! NSDictionary
        return UIFontDescriptor(name: SubStruct.preferredFontName, size: CGFloat((style[contentSize] as! NSNumber).floatValue))
    }

}

e emviewDidLoad():

label.font = UIFont(descriptor: UIFontDescriptor.preferredDescriptor(textStyle: UIFontTextStyle.body.rawValue), size: 0)
NotificationCenter.default.addObserver(self, selector:#selector(self.userChangedTextSize(notification:)), name: NSNotification.Name.UIContentSizeCategoryDidChange, object: nil)

aqui está ouserChangedTextSize função:

func userChangedTextSize(notification: NSNotification) {
    label.font = UIFont(descriptor: UIFontDescriptor.preferredDescriptor(textStyle: UIFontTextStyle.body.rawValue), size: 0)
}

O problema com esse método, o tamanho do texto não será alterado até que o usuário volte ao aplicativo e o usuário verá o tamanho antigo do texto mudar para o novo tamanho, o que não é o ideal.

Eu poderia ter o melhor dos dois mundos: uma fonte personalizada com um tamanho que muda automaticamente em segundo plano?