I’m not sure what “edits” you wish to do. As I said, it is a complex file and is maxing out my CPU in Acrobat when manually editing. You could try to simplify it first if you wish to persist in opening it into Illustrator.
Acrobat Pro has some manual editing features and Adobe license a subset of Callas software for their preflighting/fix-ups (although not manual edits).
What I am suggesting is that there are industry standard PDF editing software that may be more robust on large/complex PDF files than what Acrobat Pro offers.
Basically I'm pulling map elements out and changing their style. I was able to turn a bunch of layers off in Acrobat, go into the Edit mode, select all, and under "Objects">Edit Using...>Illustrator.