If the rear mech appears really wonky then it is possible that it has been bashed, bending the mech or the hanger. Alternatively the mech is so old that the hinges are getting worn and loose. The important thing to check is that there is no chance for the cage to drift into the spokes - if it does mech will likely die possibly bringing your rear wheel with it and worse you may go over the handlebars.
If it is only slightly unaligned and there is no risk of the above then imho if it works don't fix it.